Hipospádias. Revisão da casuística e das diferentes técnicas utilizadas--279 cases]

Resumo

A review was made of 279 children with Hypospadias treated in Pediatric Surgery Department. Hypospadias was classified in accordance with existence of chordee and position of urethral meatus. Indications and the results are discussed according to Hypospadias type and surgical procedure performed over the years. Glanular Hypospadias (144 cases) were treated as follows: 117 by meatotomy or advancement meatoplasty and postectomy with 1.09 mean interventions per patient (M I/P). 24 by MAGPI procedure with 1,12 M I/P and 3 by other procedures. Distal penil Hypospadias without chordee (87 cases), 23 were treated by Denis Browne Crawford (DBC) procedure with 2,82 M I/P, 62 by Van Der Meulen procedure with 1,48 M I/P and 2 by other procedures. Hypospadias with chordee, penile and perineal (48 cases) 35 had chordee release followed by DBC procedure with 4,0 M I/P, 7 by Duckett procedure with 2,0 M I/P and 6 by other procedures. The present tendency towards the use of single stage procedures, namely MAGPI, Van Der Meulen and Duckett is analysed. Its advantages for patients and institutions--lower M I/P, decrease of hospitalization period, repair completed earlier in life and reduced emotional damage--are balanced with aesthetical results and frequency of complications.