Older age at surgery and low surgical experience have also been associated with poorer outcomes. With longer follow-up, it is apparent that late complications can occur, and thus, most advocate continued evaluation through puberty.
Immediate postoperative concerns
Local edema and blood spotting can be expected early after repair and generally do not cause a significant problem.
Postoperative bleeding rarely occurs and is usually controlled with a compressive dressing. Infrequently, reexploration may be required to evacuate a hematoma and to identify and treat the source of bleeding.
Infection is a rare complication of hypospadias repair in the modern era. Skin preparation and perioperative antibiotics are generally used. Patients are often maintained on an antibiotic course until any stents are removed, though this has not clearly been shown to be beneficial. Long-term issues
Urethrocutaneous fistulization is a major concern in hypospadias repair. The rate of fistula formation is generally less than 10% for most single-stage repairs but rises with the severity of hypospadias, approaching 40% with complex reoperative efforts. Fistulas may close spontaneously and are repaired by using a multilayered closure with local skin flaps 6 months after the initial repair. After repair, fistulas recur in approximately 10% of patients.
Possible post-surgical complications
Note: Urethroplasty is generally well tolerated with a high rate of success, serious complications occur in fewer patients.
- Other rare complications are as follows
- Urinary incontinence (symptoms of incontinence often improve over time with strengthening exercises)
- Urinary retention/urgency/urine spraying
- Erectile dysfunction
- Loss of penile sensation, decreased tactile sensation of the penile shaft and corona