In a study carried out in Oman, all patients with 5-ARD were phenotypically male by birth.10 But they presented with micropenis, with or without
hypospadias. In our study patients of 5-ARD presented with the same clinical features.
Group 1: The long "pan-penile" stricture involving the majority of the penile urethra in the setting of previous (and often multiple)
hypospadias surgeries, Group 2: The "junctional stricture" with a
hypospadias repair deemed acceptable but having a stricture of variable length at the junction of previous
hypospadias repair and native urethra, Group 3: Isolated bulbar urethral stricture after
hypospadias repair outside of the previously repaired urethra, Group 4: Urethral stricture in the setting of previously untreated
hypospadias.
Surgery for correcting
hypospadias involves three main steps
Sixteen (16%) patients had a history of one or more
hypospadias repair surgery, 82 (84%) had primary
hypospadias surgery.
Keywords: Fistula,
Hypospadias, Stent, Urethroplasty.
Successful surgical correction of true diphallia, scrotal duplication, and associated
hypospadias. J Pediatr Surg 2006;41:13-4.
Research Problem, Knowledge Gap and Research Question: There are many studies in global, regional, national and local literature showing separately the counts of urethrocutaneous fistula following Snodgrass and two stage Aivar Bracka procedure for repair of distal penile
hypospadias in male children in different populations.
It is tempting to speculate that epigenetic mechanism(s) could also play an important role in the regulation of primary (sensory/signaling) cilium function and the disruption of such mechanism(s) in the spatiotemporal fashion could affect the development of external male genitalia resulting in diphallia and
hypospadias.
After approval by our institutional review board, we prospectively enrolled patients between 6 months and 2 years of age with mid-to-distal shaft
hypospadias scheduled for elective primary
hypospadias repair at our institution between June 2013 and May 2017.
A First:
hypospadias, if mild, probably doesn't have to be repaired at all.
A 3-year-old boy referred to our unit for further evaluation of micropenis, penoscrotal
hypospadias, and a history of operated unilateral cryptorchidism.
With this approach, a child would no longer need to suffer from complications of the current treatment for
hypospadias.