EN
TÜRKÇE
Poster - 195
Outcomes of staged tubularized auto-graft repair(STAG) for proximal hypospadias: Experience of a tertiary pediatric surgery center in Bangladesh
Samidur Rahman 1, Fatema Sayeed 2, Muhammed Moinul Haque 2, Khairul Basher 2, Shahin Reza 1, Nazmul Haider Chowdhury 1
1 Dhaka Medical College Hospital, Bangladesh, Department of Pediatric Surgery
2 Dhaka Medical College Hospital, Bangladesh, Deapartment of Pediatric Urology
Purpose:
Proximal hypospadias with severe chordee poses surgical challenges. The two-stage (STAG) procedure has emerged as a preferred technique in such cases due to its favorable outcomes in complex anatomy. This study aims to evaluate our experience with staged hypospadias repair at a high-volume tertiary care pediatric surgery center in Bangladesh.
Method:
A retrospective analysis was conducted on patients who underwent two-stage hypospadias repair between January 2022 and December 2024. Index cases with proximal hypospadias (penoscrotal, scrotal, or perineal) with severe chordee were included. Stage 1 involved chordee correction, mobilization of proximal urethra up to the bulbar part, grafting with preputial skin, and wide glans wing with wide graft. Stage 2 involved tubularization after a minimum interval of 6 months. Testosterone cream was used to facilitate the second stage. Demographic data, operative details, complications, and functional outcomes up to 6 months were analyzed.
Results:
A total of 50 patients underwent staged repair during the study period. The median age at first-stage surgery was 5 years. Complete penile straightening was achieved in 92%, and partial graft rejection was present in 4% after Stage 1. Stage 2 repair was completed after a mean interval of 9 months. The most common complication was urethrocutaneous fistula (12%), followed by glans dehiscence (10%), meatal stenosis (8%), and stricture (4%).
Conclusion:
The staged repair approach remains a reliable option for complex hypospadias in our setting, with acceptable complication rates and good functional outcomes. Key factors for success include adequate urethral mobilization, use of healthy preputial grafts, and meticulous surgical technique. Further prospective studies with long-term follow-up are warranted to evaluate outcome and patient satisfaction.