Outcomes of Management of Hypospadias at a Teaching Hospital in Nigeria

L. Abdur-rahman, Aa Nasiru, A. Adeyeye, J. Adeniran
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引用次数: 2

Abstract

Hypospadias is a congenital malformation of the urethra that requires surgical correction in children. This poses some challenges to the surgeon especially where facilities are lacking. There is scanty report of encounters in the management of this condition from our subregion. Hence, we retrospectively reviewed the presentation and outcome of management of hypospadias at a tertiary health facility in Nigeria between Jan 2002 and Oct. 2009.There were 61 children with hypospadias during the period of which 47 (77.1%) had urethroplasty and this comprised 11 proximal, 4 midshaft and 32 distal types. Their ages ranged between 2 months and 14 years, median= 18 months. Ten patients declined surgery and 4 are awaiting intervention because of age and size of penis. Co-morbidities were ambiguous genitalia 3, Down's syndrome 1, undescended testis 3 and 2 haemoglobin SS patients. Five patients presented with circumcised hypospadias. Various techniques of urethroplasty were done with improvised equipments due to resource limitation. There was no mortality but complication rate was 36.7% which included 9 post- urethroplasty fistulas and 2 with complete dehiscence that needed a secondary repair. There were 3 post operative morbidity out of 5 circumcised hypospadias (p=0.127). Length of hospital stay was between 1 and 18 days (median 7.8 days). In conclusion, there is need for public education about hypospadias presentations to prevent delay referral and undue circumcision. Provision of appropriate equipments will facilitate better outcome of paediatric urethroplasty.
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尼日利亚一家教学医院尿道下裂治疗的结果
尿道下裂是一种需要手术矫正的先天性尿道畸形。这给外科医生带来了一些挑战,特别是在缺乏设备的地方。几乎没有关于我们分区域在处理这一情况方面遭遇的报告。因此,我们回顾性地回顾了2002年1月至2009年10月期间在尼日利亚一家三级医疗机构治疗尿道下裂的表现和结果。本组共有61例尿道下裂患儿,其中47例(77.1%)行尿道成形术,其中近端11例,中轴4例,远端32例。年龄在2个月至14岁之间,中位数为18个月。由于年龄和阴茎的大小,10名患者拒绝手术,4名患者正在等待干预。合并症为生殖器模糊3例,唐氏综合征1例,睾丸隐睾3例和血红蛋白SS 2例。5例患者行尿道下裂包皮环切术。由于资源的限制,各种方法的尿道成形术都是用临时设备完成的。无死亡,并发症发生率为36.7%,其中9例为尿道成形术后瘘管,2例为完全性裂口,需要二次修复。5例尿道下裂行包皮环切术后有3例术后并发症(p=0.127)。住院时间为1至18天(中位7.8天)。总之,有必要对尿道下裂的表现进行公众教育,以防止延迟转诊和不适当的包皮环切。提供适当的设备将有助于提高儿科尿道成形术的效果。
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