Zusammenfassung
Trotz verbesserter Technik und technischer Ausstattung liegt die Komplikationsrate bei Hypospadiekorrekturen zwischen 20 und 30%. Verschiedene Aspekte wie Verbandstechnik und andere sind wesentlich für die Prävention von Komplikationen.
Frühkomplikationen beinhalten v. a. Blutungen, Hämatome und Infekte. Spätkomplikationen sind Fisteln, Meatusstenosen, Hautnekrosen, Restverkrümmungen, Harnröhrenstrikturen, Haare in der Urethra bis hin zu den Hypospadiekrüppeln. Es sollte eine exakte präoperative Diagnostik erfolgen. Verschiedene operative Techniken kommen in Betracht bis hin zur Verwendung von Meshgraft oder Fremdmaterial. Oft sind mehrzeitige Operationen notwendig. Die Operation von ausgeprägten Komplikationen ist ein anspruchsvoller rekonstruktiver Eingriff, der dem erfahrenen Operateur vorbehalten sein sollte.
Abstract
The complication rate of hypospadias repair still ranges between 20 and 30%, although operative skills and technical devices have improved. Different aspects like dressing are important for prevention of complications.
Early complications are bleeding, hematoma, and infection. Late complications are fistulas, meatal stenosis, partial and complete breakdown, persisting curvature, a hairy urethra, and hypospadias cripples. Detailed preoperative diagnostics are important. There are several operative techniques that can be used for repair including the use of mesh graft or foreign material. Two or multiple stages are often needed. The surgery to correct complications after hypospadias repair is a challenge, which should only be done by an experienced surgeon.
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Beuke, M., Fisch, M. Salvagestrategien nach Komplikationen der Hypospadiechirurgie. Urologe 46, 1670–1675 (2007). https://doi.org/10.1007/s00120-007-1588-y
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DOI: https://doi.org/10.1007/s00120-007-1588-y