Complex Hypospadias in Adults: Primary Repair and RE-DO Surgery

  • Marta R. BizicEmail author
  • Borko Stojanovic
  • Miroslav L. Djordjevic


Hypospadias is one of the most common congenital urogenital anomalies with an incidence of 1 in 200 male livebirths, so it is certain that an adult urologist will see and treat at least one of these patients for primary repair or for some late postoperative complication. More than 300 different surgical techniques and their modifications have been reported, which only proves the complexity of the anomaly.

Hypospadias repair is usually performed in youth. There is a widespread belief that the success rate is much higher in children than in adults, because of differences in anatomy, tissue quality, physiological characteristics as well as histological features of the urethral plate and other structures. Some of the patients who have undergone hypospadias repair in childhood are lost to follow-up in puberty when the late complications of an initially successful hypospadias repair might arise. Repair of late hypospadias complications poses a great incitement for the reconstructive urologist. A crippled penis, as the most difficult form of unsuccessful treatment, presents the greatest challenge for surgeons, as these patients are prone to the highest complication rates which can have a huge impact on their psychosexual functioning.

Hypospadias should be treated in childhood as this guarantees a high success rate. Long-term follow-up of these patients should continue from childhood to adulthood for psychosexual function, micturition and esthetic appearance in order to adequately treat prospective complications on time.


Hypospadias Adults Extracellular matrix (ECM) Surgical repair Long-term follow-up Complications RE-DO surgery 



This paper is supported by Ministry of Education, Science and Technological Development, Republic of Serbia, Project No. 175048.

Conflict of Interests

The Authors declare no conflict of interest.


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Marta R. Bizic
    • 1
    • 2
    Email author
  • Borko Stojanovic
    • 1
    • 2
  • Miroslav L. Djordjevic
    • 1
    • 2
  1. 1.University Children’s Hospital, Faculty of MedicineUniversity of BelgradeBelgradeSerbia
  2. 2.Belgrade Center for Genitourinary Reconstructive SurgeryUniversity of BelgradeBelgradeSerbia

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