Outcomes of Hypospadias Repair in Older Children: A Prospective Study

Purpose The current American Academy of Pediatrics (AAP) recommendation is to perform Hypospadias repair at age 6 to 12 months. We report and compare outcomes for a group of patients who underwent primary Hypospadias repair at different age groups. Material and Methods In a prospective study we report on all distal Hypospadias cases undergoing primary repair at our institution over a 7 months period. Our parameters included age, degree of Hypospadias, surgical technique and complications rates. Results 61 patients all underwent tubularized incised plate repair. More severe forms of Hypospadias or different repairs were excluded. Patients were classified into three groups according to age. Group A from 6 months to 2 years (25 patients, 40%), group B from 2 to 4 years (17 patients, 28%) and group C were 4 years or older (19 patients, 32%). Only 6 (9.8%) patients had postoperative complications all in the older groups. In group B, there were 3 (17.6%) complications, in the form of one (5.88%) case of loss of repair, one (5.88%) case of meatal stenosis and one (5.88%) case of hematoma. In group C, there were 3 (15.8%) cases of postoperative fistula. The incidence of fistulas was higher in group C (p value= 0.032). Conclusions Despite previous reports suggesting much higher incidence of complications in older children, we found that the complication rates are within the acceptable range for infant Hypospadias repair. However these complications were statistically significant between the older groups compared with the recommended age group.