African Journal of Paediatric Surgery

ORIGINAL ARTICLE
Year
: 2011  |  Volume : 8  |  Issue : 3  |  Page : 286--290

Choosing a technique for severe hypospadias


Alexis Arnaud1, Luke Harper1, Marie-Benedicte Aulagne1, Jean-Luc Michel1, Aude Maurel1, Eric Dobremez1, Laurent Fourcade1, Lalatiana Andriamananarivo2 
1 Department of Paediatrics Surgery, CHR F Guyon, Saint-Denis, Reunion Island
2 Department of Paediatrics Surgery, CHU, Antananarivo, Madagascar

Correspondence Address:
Luke Harper
Department of Paediatric Surgery, CHR F Guyon, Bellepierre, Saint-Denis de La Réunion, 97405. Reunion Island

Introduction: We participate in humanitarian missions in Madagascar during which we treat severe hypospadias. We report our experience and results with these patients, in these conditions, and discuss our choice of technique in this particular setting. Materials and Methods: We retrospectively reviewed the data of 27 patients operated for severe hypospadias during our humanitarian missions in Madagascar between November 2006 and September 2009. Twenty one patients underwent a modified Koyanagi procedure, three underwent a Duckett urethroplasty, two an onlay island flap, one an augmented Duckett and one a tubularised plate urethroplasty. Two patients who underwent a modified Koyanagi repair also had a Nesbitt dorsal plication. Results: Patient age at the time of surgery ranged from 22 to 198 months with a median age of 54.1 months. Mean follow-up was 16 months. Of the 21 patients who underwent a modified Koyanagi procedure, 16 presented at least one complication (76%): A fistula developed in 12 patients (57%), meatal regression developed in 7 (33%) and 2 showed complete wound dehiscence (9.5%). None developed stenosis or urethrocoele. Conclusion: In this particular setting, the postoperative complication rate is high. Nevertheless, the Koyanagi technique is appropriate, because its complications are easy to treat and there is always sufficient ventral tissue for the secondary operation, if necessary.


How to cite this article:
Arnaud A, Harper L, Aulagne MB, Michel JL, Maurel A, Dobremez E, Fourcade L, Andriamananarivo L. Choosing a technique for severe hypospadias.Afr J Paediatr Surg 2011;8:286-290


How to cite this URL:
Arnaud A, Harper L, Aulagne MB, Michel JL, Maurel A, Dobremez E, Fourcade L, Andriamananarivo L. Choosing a technique for severe hypospadias. Afr J Paediatr Surg [serial online] 2011 [cited 2019 Nov 14 ];8:286-290
Available from: http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2011;volume=8;issue=3;spage=286;epage=290;aulast=Arnaud;type=0