Les différentes techniques chirurgicales de l'hypospadias postérieur

Abstract

is a congenital malformation where the urethral meatus's opening is ectopically on the ventral side of the penis. This anomaly may be accompanied by a chordee, an ectopic meatus's stenosis, an incomplete foreskin, a simple deviation of the median raphe, a buried penis, a scrotal transposition or a corpus cavernosum's hypoplasia. Our work is about 21 cases of proximal hypospadias gathered at Surgery Pediatric hospital of Tlemcen Children's Hospital over a 3-year period from January 2018 to December 2020. The average age of the treated children was less then 2 years old. only 1 case have a family history of hypospadias (5%). The associated abnormalities were: chordee (100%), micropenis (29%), sex differentiation abnormality (10%), testicular ectopy (81%). Different surgical techniques were used: Duckett and Koyanagi are the most used (57%). other surgical techniques are: Onlay (19%), Duplay (19%) and Bracka (5%). The most common postoperative complications were hematoma (14%), urethral fistulas (24%), meatal stenosis (5%), residual chordee (indefinite rate), urethral stricture (5%) and urethral diverticula (5%). The techniques diversity suggested to treat the proximal hypospadias caused a great debate between the uropediatrists on the long-term cosmetic result and the mictionnel and sexual functioning. Our study aims to evaluate the efficacy of these different surgical options, and to compare them with the data of the medical literature and with the last recommendations to operate the proximal hypospadias.