Clinical Profiles and Surgical Outcome Of Hypospadias Repair in Pediatric Surgery at Jimma University Medical Center, Jimma, Ethiopia

Abstract

Background: Hypospadias is one of the most common birth defect standing second after cryptorchidism in male. Surgery is the only effective treatment for hypospadias. If hypospadias is not managed appropriately and timely, it will affect the patient’s psychological, emotional and sexual well-being. Despite advent of safe anesthesia, and advanced surgical techniques, the incidence of postoperative complication is significant and it remains a great challenge for pediatric urologists and surgeons. Studies regarding hypospadias pattern and outcome are lacking in Low and middle income countries including Ethiopia. Thus this study was conducted to assess the clinical profiles and outcomes of hypospadias patients who underwent surgery at Jimma University Medical center (JUMC) Pediatrics surgical unit. Methods: This is a descriptive cross-sectional study conducted at JUMC on all pediatric patients who underwent surgery for hypospadias between 1 May 2018 and 30 April 2023. Predesigned extraction checklist was utilized for data collection and SPSS version 24 was used for data entry and analysis. Results: A total of 86 patients, who were operated for hypospadias, were included by fulfilling the selection criteria. The mean age at surgery was 3.7yr (Range, 4months-14 years) and only one-third, 27(31.4 %) patients were operated on in the recommended age group (6 18 months). Anterior/distal hypospadias was the most common 37(43%) followed by Middle, 36(42%). The majority had chordee 46(53.5%) and 35(76.1%) were severe forms. Tubularized incised plate repair 51(59.3%) was the major surgical technique employed for anterior and middle hypospadias, while staged urethroplasty was used in 20(23.5%) of patients mostly with posterior hypospadias. Post-operative complications occurred in 30(34.9%) patients and the commonest was urethrocutanous fistula 15(50%). No significant correlation was found between the occurrence of these complications and other factors. Conclusion: Most patients were presenting lately for hypospadias repair and anterior hypospadias was the most common type of hypospadias. Recommendation: Public awareness creation concerning hypospadias should be done.