Risks and relevance of preputial reconstruction in hypospadia repair.

AIM: To assess the risks related to preputial reconstruction and its relevance for parents of children undergoing hypospadias repair. MATERIALS AND METHODS: One-hundred-and-eighty-six children with distal hypospadias underwent circumcision or preputial reconstruction during the hypospadias repair. The type of procedure was chosen according to anatomical conditions and parents preferences after a careful explanation of possible related risks. Postoperative complications, outcomes, parents' satisfaction were assessed comparing circumcised and uncircumcised patients. RESULTS: No statistical differences in urethral complications were found between the two groups. Urethral or meatal strictures occurred in 11 (6.9%) cases after preputioplasty and in 2 (7.4%) cases after circumcision. Fistulas occurred in 8 (5%) cases after preputial reconstruction and in 1 (3.7%) after circumcision. Preputial reconstruction involved 6 cases (3.7%) of dehiscence and 10 of phimosis (6.2%) as specific complications of this procedure. After a mean follow-up of 3.7 years all the parents stated to be satisfied of the cosmetic results. CONCLUSION: Preputial reconstruction is feasible in many patients with distal hypospadias and it should be considered in accordance with parents' preferences. Parents should be informed that this procedure involves an increased risk of complications in hypospadias repair.