How to diagnose and treat complex hypospadias

  Hypospadias is a common congenital malformation of the male genitourinary system, characterized by hypospadias with the opening of the external opening on the ventral side of the penis, mostly accompanied by ventral curvature of the penis. The incidence of hypospadias in the general population is about 1‰ to 8‰, and the treatment of hypospadias is a hot topic in pediatric urology. As many as 200 surgical methods have been applied, but there is not yet a surgical method that is acceptable to the majority of physicians. The main problem is that there are many postoperative complications, such as: urinary fistula, urethral stricture, urethral diverticulum, etc. Zhu Yingjian, Department of Urology, Shanghai Xinhua Hospital The current surgical approach for hypospadias (Duckett-Onlay procedure), i.e., after completely straightening the penis, using the inner plate of the dorsal foreskin of the penis, separating a flap with a vascular tip and sewing around the stent roll to form a new urethra in the shape of a tube, enables the success rate of the operation to reach more than 90% and reduces complications such as urinary fistula. Also in the area of complex hypospadias, we have applied various methods to successfully cure complex hypospadias and recurrent hypospadias after multiple surgeries.