Outcomes of hypospadias repair in a university hospital in Dakar, Senegal

Abstract

Background: Hypospadias is a congenital abnormality due to hypoplasia of the ventral penile tissues. Hypospadias surgery has benefited from a better understanding of penile anatomy and improved instrumentation. In sub-Saharan Africa, particularly in Senegal, hypospadias surgery remains a challenge due to limited equipment. Our study aimed to evaluate the results of hypospadias surgery at a referral centre in a resource-limited country.

Patients and methods: This was a retrospective descriptive study of 126 patients treated at our centre over six years. The most used surgical techniques were Duplay, Snodgrass, Mathieu, and Duckett.

Results: The postoperative complication rate was 39.7%. Urethrocutaneous fistula was the most common complication (24%). Other complications included suture release (8.7%), meat stenosis (4%), residual curvature with an unsatisfactory aesthetic appearance (3%). After a follow-up of 3–24 months, outcomes were good in 54% of cases, intermediate in 9.5%, and failed in 36.5%. Results for anterior forms were better compared with those for midshaft and posterior forms (p = 0.002). The good results were predominant in patients aged 0–6 years. There was no statistical difference in urine drainage type.

Conclusion: Hypospadias surgery is challenging in developing countries, with high rates of complications. To improve results, it is necessary to improve equipment and postoperative care.