Introduction and Objectives
Real incidence of curvature in hypospadias is not clearly defined. It is generally accepted that curvature is most common in proximal forms, while rare in distal hypospadias. Starting from 2004, we established the rule that any form of hypospadias has to be checked for curvature during its repair by either pharmacological (PGE1) or arteficial erection induced by infiltrating saline solution under presure into the corporal bodies. Our aim was to define real incidence of curvature within various forms of hypospadias, in order to signify preoperative and intraoperative diagnosis of chordee as a part of hypospadias repair.
Material and Methods
We retrospectively rewieved 454 patients who underwent hypospadias repair at our department. The patients were distributed in two groups; those who were treated between 2005–2008, and those who underwent surgery from 2001 to 2004. In the first group (256 pts.), all patients were tested for chordee after degloving as a standard part of surgical procedure. In second group (198pts.) arteficial erection as a test for presence of the chordee was not done and only visible curvatures were corrected.
Results
Out of 454 cases, in 104 (22.9%) curvature was diagnosed and surgically corrected during hypospadias repair. In the first group, penile curvature was diagnosed and treated in 81 (31.6%) patients, while in second correction of curvature was done in 23 patients (11.6%). In the patients with distal forms of hypospadia, in the first group, curvature was diagnosed and corrected in 38.2%, while in the patients belonging to the second group having the same distal form of hypospadia curvature was noted and correted in only 6.8%.
Conclusions
Our results show significantly higher incidence of curvature in hypospadias, especially in its distal forms, in group in whitch testing of curvature was performed. This is the reason why all forms of hypospadias should be checked for presence of curvature and corrected during surgery.
Article info
Identification
Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
