Difficulties of hypospadias management: A multicentric retrospective case series in the city of Kinshasa

Abstract

Context and objective. Hypospadias is a common urogenital malformation which is difficult to treat. The objective of this study was to evaluate the results of different urethroplasty procedures used in the hypospadias repair. Methods. This was a descriptive case series of patients with hypospadias attending five hospitals in Kinshasa from January 2014 to January 2024. The variables of interest were sociodemographic, clinical and paraclinical parameters. The location of the meatus was categorized according to the Orkiszewiski classification and the results after surgery were considered successful in the absence of complications. Results. A total of 46 patients had been followed for malformative uropathies over a period of 10 years. Hypospadias (73.91%) was the most common malformation. The mean age of patients was 8.38±4.57 years; its hospital prevalence had a peak in 2022 (17 cases); the meatal ectopy was anterior in 55.88% of cases and was associated with the chordee in 14.7% of cases. The average number of previous surgeries was 1.016±1.36 with extremes from 1 to 5; the urethroplasty procedures were: Duplay (47.06%), Bracka (29.41%), Onlay (17.65%) and Cahuzac (5.88%). After surgery, success was observed in 79.41% of cases; no statistically significant link was found between the urethroplasty procedures and the postoperative evolution; the success rate depended on the notion (p˂0.001) and the average number (p=0.035) of previous surgeries. Conclusion. Hypospadias surgery is quite complex with a high rate of complications requiring iterative repairs. Received: December 9th, 2024Accepted: April 2nd, 2025 https://dx.doi.org/10.4314/aamed.v18i3.14