Clinical Profile, Factors Associated with Early Complications and Patients Satisfaction Assessment of Hypospadias Repair at Bugando Medical Centre, Mwanza Tanzania.
Material type:
Item type | Current library | Collection | Status | Barcode | |
---|---|---|---|---|---|
POSTGRADUATE DISSERTATIONS | MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO | NFIC | 1 | PD0316 |
ABSTRACT:
Background: Hypospadias account for 4.5% of all admission in urology department and the leading pediatric urological condition in Bugando Medical Centre. Poor outcome after hypospadias repair is universally high and patients/ parental satisfaction always diverse. This study describes the anatomical pattern of the condition and determines the factors associated with early post operative complications.
Methods: This was both retrospective and prospective hospital based study involving all male patients who underwent hypospadias repair at Bugando Medical Centre from May 2018 to April 2019.There was a follow up of a month post repair. Data were entered in Excel sheet and processed and analyzed by STATA version13. Univariate and multivariate logistic regression were used in determining the factors associated with 30 days post operative complication.
Results: A total of 66 patients were studied, their median age was 3years IQR [9months to 13years], and 83.3% (n=55) had distal hypospadias. There were 18.2% (n=12) patients who needed repeating repair and 30.3% (n=20) with chordee into which 90% (n=18) were corrected by degloving. Unilateral maldescended testis was in 10.6% (7/66). TIP was the procedure of choice in 75.7% of the patients and staged only in 9.1%. Early complication was observed among 43.9 %( n=29/66) patients with UCF being 31.2% (n=20). Patient age <2yrs p value 0.01, re do operations p value 0.02, presence of chordee p value < 0.01, choice of suture materialvicryl 4.0 p value < 0.01 and urine drainage p value 0.02, were associated with early complication.
Conclusion: In our setting hypospadias repair is associated with higher early complication rate of 43.9%. urethrocutaneous fistula was the leading early complication but 10% closed spontaneously within a month. Repeating repairs, vicryl 4.0 as a suture material, urinary drainage of more than 10days, presence of chordee and age ≤ 2years were statistically associated with early complications Using HOSE for outcome assessment 80.3% of the parental/patients were satisfied with the early outcome of hypospadias repair.
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