Hypospadia Surgery
Hypospadias is a congenital malformation related to an alteration in the prenatal development of the urethra. The therapeutic objectives are to correct the curvature of the penis if present, create a neourethra of adequate size, position the new meatus at the tip of the glans if possible, and achieve an overall acceptable aesthetic appearance.
Currently, most cases of hypospadias are successfully treated in the early years of life, thus helping to limit the psychological impact associated with this condition. Correction of hypospadias in adults is rare, and when it occurs, we often face complications arising from previously unsuccessful surgeries.
Numerous surgical techniques exist for the correction of this condition. The choice of the most appropriate approach depends on the severity of the case, the preferences of the patient, and the experience of the surgeon. Among the most used techniques are:
- The Mathieu technique, in which the neourethra is formed from a mucosal flap taken from the inner surface of the glans.
- The Snodgrass technique, in which the neourethra is reconstructed by tubularizing the ventral surface of the penis.
- The Bracka technique, which involves two surgical stages. In the first stage, the ventral surface of the glans is enlarged using a graft, usually of buccal mucosa, and then tubularized in a second surgical stage about 6 months after the first.
This surgery is not free from complications, with the most common being urethral strictures or fistulas. In particular, the complication rate is about 10% for distal repairs and 25% for proximal repairs.
The surgical treatment of hypospadias aims to restore not only the functional aspect of the penis but also its aesthetic aspect. This congenital condition can affect the patient’s life in various ways, making precise and targeted intervention essential. Surgery for hypospadias is a delicate procedure that requires technical skill and meticulous planning to ensure the best possible results. For this reason, it is essential to consult experienced specialists in the field of reconstructive urologic surgery to optimize outcomes and reduce the risk of postoperative complications, thereby improving the quality of life for the patient.
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