Hypospadias repair in adults: Adventures and misadventures

Purpose: To evaluate long-term results and complications we reviewed the re cords of 42 consecutive men 18 to 47 years old (mean age 22.5) who underwen t hypospadias repair between 1979 and 1999. Materials and Methods: The study population was divided into groups 1 consi sting of 8 patients without previous hypospadias surgery, 2 consisting of 1 2 who underwent 1 or more procedures in childhood but in whom local tissue was relatively intact and 3 consisting of 22 who underwent multiple unsucce ssful hypospadias repairs with various degrees of penile deformity and loss of local tissue. Results: Complications were noted in 3 of 8 (37.5%), 5 of 12 (41.67%) and 1 4 of 22 (63.6%) patients in groups I to 3, including 3 (100%), 4 (80%) and 10 (71.4%), respectively, in whom secondary surgery was successful in the l ong term. A patient in group 2 and 2 in group 3 await further surgery, whil e 2 in group 3 were lost to followup. Overall primary complications develop ed in 22 of the 42 men (52.3%) and 5 of the 22 (22.7%) had secondary compli cations. There was long-term success in 37 of 42 cases (88.1%). Conclusions: The results of hypospadias repair in adulthood differ from the results of similar procedures in childhood. Although the various technique s are similar, there is clearly a difference in terms of wound healing, inf ection, complication rates and overall success. Adults undergoing hypospadi as repair must be counseled on all of these variables to avoid unreasonable expectations.