Common Practice of Hypospadias Management by Pediatric Urologists in Indonesia: A Multi-center Descriptive Study from Referral Hospitals

Gede Wirya Kusuma Duarsa; Pande Made Wisnu Tirtayasa; Besut Daryanto; Pradana Nurhadi; Johan Renaldo; Tarmono Tarmono; Trisulo Utomo; Prahara Yuri; Safendra Siregar; Irfan Wahyudi; Gerhard Reinaldi Situmorang; Muhammad Asykar A. Palinrungi; Yonas Immanuel Hutasoit; Andre Yudha Alfanius Hutahaean; Yevri Zulfiqar; Yacobda H. Sigumonrong; Hendy Mirza; Arry Rodjani

doi:10.3889/oamjms.2019.628

Authors

Gede Wirya Kusuma Duarsa Divison of Urology, Department of Surgery, Faculty of Medicine Universitas Udayana, Sanglah Hospital, Denpasar, Indonesia
Pande Made Wisnu Tirtayasa Division of Urology, Department of Surgery, Faculty of Medicine Universitas Udayana/Sanglah Hospital, Bali
Besut Daryanto Department of Urology, Faculty of Medicine Universitas Brawijaya, Saiful Anwar Hospital, Malang, Indonesia
Pradana Nurhadi Department of Urology, Faculty of Medicine Universitas Brawijaya, Saiful Anwar Hospital, Malang, Indonesia
Johan Renaldo Department of Urology, Faculty of Medicine Universitas Airlangga, Soetomo Hospital, Surabaya, Indonesia
Tarmono Tarmono Department of Urology, Faculty of Medicine Universitas Airlangga, Soetomo Hospital, Surabaya, Indonesia
Trisulo Utomo Department of Urology, Faculty of Medicine Universitas Gadjah Mada, Sardjito Hospital, Yogyakarta, Indonesia
Prahara Yuri Department of Urology, Faculty of Medicine Universitas Gadjah Mada, Sardjito Hospital, Yogyakarta, Indonesia
Safendra Siregar Department of Urology, Faculty of Medicine Universitas Padjajaran, Hasan Sadikin Hospital, Bandung, Indonesia
Irfan Wahyudi Department of Urology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Gerhard Reinaldi Situmorang Department of Urology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Muhammad Asykar A. Palinrungi Division of Urology, Department of Surgery, Faculty of Medicine Universitas Hasannudin, Wahidin Sudirohusodo Hospital, Makassar, Indonesia
Yonas Immanuel Hutasoit Department of Surgery, Fatmawati Hospital, Jakarta, Indonesia
Andre Yudha Alfanius Hutahaean Department of Surgery, Harapan Kita Hospital, Jakarta, Indonesia
Yevri Zulfiqar Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Andalas, M.Djamil Hospital, Padang, Indonesia
Yacobda H. Sigumonrong Department of Urology, Faculty of Medicine, Universitas Sumatera Utara, Adam Malik Hospital, Medan, Indonesia
Hendy Mirza Department of Surgery, Persahabatan Hospital, Jakarta, Indonesia
Arry Rodjani Department of Urology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2019.628

Keywords:

Hypospadias, Urethroplasty, Complications, Urethrocutaneous fistulae

Abstract

BACKGROUND: Hypospadias is the second most common congenital anomalies among human congenital disabilities. There are over 300 surgery techniques being introduced to treat hypospadias. The successful of hypospadias repair is assessed by several outcomes as well as complications following surgery.

AIM: This study aims to show the multicenter hypospadias data in Indonesia descriptively.

METHODS: All the data were compiled based on questionnaires, which were distributed to Indonesian pediatric urologists. The questionnaire includes several questions containing demographic aspect, preferred techniques being used, and complications being found regarding hypospadias repair.

RESULTS: Eighteen Indonesian pediatric urologists from 12 centres involved in this study. The data were collected from June â€“ September 2018 based on the surgeonâ€™s experience throughout 2017. From 591 cases based on the returned questionnaire, penile-type hypospadias was the most common type of hypospadias being treated (35.7%) followed by penoscrotal (28.9%) and scrotal-type (12.9%). Moderate severity of chordee was mostly seen among all cases (40.6%). Tubularised incised plate (TIP), + Thiersch Duplay, was the most common technique being used to treat hypospadias (44.3%), followed by onlay island preputial flap (14.9%) and two-stage technique (14%). The incidence of urethrocutaneous fistulae in this study was 13.9%.

CONCLUSION: This study showed how Indonesian pediatric urologists dealt with hypospadias cases. TIP + Thiersch Duplay procedure being the preferred technique used by most participants and the rate of urethrocutaneous fistulae as one of the complications was comparable with previous studies.