EXPERIENCE IN THE SURGICAL MANAGEMENT OF PROXIMAL HYPOSPADIAS IN CHILDREN AT THE REPUBLICAN SPECIALIZED SCIENTIFIC AND PRACTICAL MEDICAL CENTER OF UROLOGY
Keywords:
proximal hypospadias, children, urethroplasty, Bracka technique, reconstructive surgery, pediatric urology, surgical outcomesAbstract
Proximal hypospadias represents one of the most complex congenital anomalies of the male external genitalia in children and is associated with a considerable risk of postoperative complications. This study evaluated the outcomes of surgical treatment in 66 children with various forms of proximal hypospadias who received treatment at the Republican Specialized Scientific and Practical Medical Center of Urology. Particular attention was given to preoperative preparation, the selection of reconstructive techniques, postoperative management, and early treatment outcomes. The findings demonstrated that a differentiated surgical approach, including two-stage Bracka urethroplasty in patients with severe tissue deficiency and complex anatomical presentations, was associated with a lower incidence of postoperative complications, a reduced need for secondary surgical procedures, and favorable functional and cosmetic outcomes. The clinical experience presented in this study supports the effectiveness of contemporary reconstructive techniques in the surgical management of proximal hypospadias in pediatric patients.
References
1. Snodgrass W. Tubularized incised plate urethroplasty for distal hypospadias. Journal of Urology. 1994;151(2):464–465.
2. Bracka A. A versatile two-stage hypospadias repair. British Journal of Plastic Surgery. 1995;48(6):345–352.
3. Baskin LS, Ebbers MB. Hypospadias: Anatomy, etiology, and technique. Journal of Pediatric Surgery. 2006;41(3):463–472.
4. Springer A. Assessment of outcome in hypospadias surgery. Nature Reviews Urology. 2014;11(10):606–613.
5. Hadidi AT, Azmy AF. Hypospadias Surgery: An Illustrated Guide. 2nd ed. Berlin: Springer; 2017.
6. Mouriquand PDE, Gorduza DB, Gay CL, et al. Surgery in disorders of sex development (DSD) with a gender issue: If, when, and how? Journal of Pediatric Urology. 2016;12(3):139–149.
7. European Association of Urology. EAU Guidelines on Paediatric Urology. Arnhem: European Association of Urology; 2024.
8. Campbell-Walsh-Wein Urology. 13th ed. Philadelphia: Elsevier; 2024. Chapter: Hypospadias and Urethral Development.