Iatrogenic hypospadias – a preventable rare complication with two-stage repair with buccal mucosa graft: a case presentation


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Abstract

Urethral catheterization is a common procedure, but it is associated with a number of complications. Iatrogenic hypospadias can rarely occur. There is a limited literature dedicated to this condition. We report a young patient with COVID-19 with iatrogenic hypospadias of grade 3. He was undergone to a two-stage procedure with acceptable outcome. Surgical repair should be offered and performed for young patients to ensure good function with acceptable penile appearance. A surgical treatment will improve psychological, sexual and social outcomes.

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About the authors

M. R. Yusof

Hospital Serdang; Hospital Sultan Abdul Aziz Shah UPM

Email: drkhairulasri@gmail.com

Department of Urology; Department of Urology

Malaysia, Serdang; Serdang

M. F. Mohd Sharin

Hospital Serdang; Universiti Putra Malaysia; Hospital Sultan Abdul Aziz Shah UPM

Email: drkhairulasri@gmail.com

Department of Urology; Department of Urology, Faculty of Medicine and Health Sciences; Department of Urology

Malaysia, Serdang; Serdang; Serdang

I. Aizat Sabri

Hospital Serdang; Hospital Sultan Abdul Aziz Shah UPM

Email: drkhairulasri@gmail.com

Department of Urology; Department of Urology

Malaysia, Serdang; Serdang

A. V. Jagwani

Hospital Serdang; Hospital Sultan Abdul Aziz Shah UPM

Email: drkhairulasri@gmail.com

Department of Urology; Department of Urology

Malaysia, Serdang; Serdang

F. Y. Lee

Hospital Serdang; Universiti Putra Malaysia; Hospital Sultan Abdul Aziz Shah UPM

Email: drkhairulasri@gmail.com

Department of Urology; Department of Urology, Faculty of Medicine and Health Sciences; Department of Urology

Malaysia, Serdang; Serdang; Serdang

A. I. Ahmad Zaidi

Hospital Sultan Abdul Aziz Shah UPM

Email: drkhairulasri@gmail.com

Plastic and Reconstructive Unit, Department of Surgery

Malaysia, Serdang

M. Z. Saiful Azli

Hospital Sultan Abdul Aziz Shah UPM

Email: drkhairulasri@gmail.com

Department of Urology

Malaysia, Serdang

R. K. Rishitra

Hospital Sultan Abdul Aziz Shah UPM

Email: drkhairulasri@gmail.com

Department of Urology

Malaysia, Serdang

O. Fahmey

Hospital Serdang; Universiti Putra Malaysia; Hospital Sultan Abdul Aziz Shah UPM

Email: drkhairulasri@gmail.com

Department of Urology; Department of Urology, Faculty of Medicine and Health Sciences; Department of Urology

Malaysia, Serdang; Serdang; Serdang

C. K. S. Lee

Hospital Serdang; Universiti Putra Malaysia; Hospital Sultan Abdul Aziz Shah UPM

Email: drkhairulasri@gmail.com

Department of Urology; Department of Urology, Faculty of Medicine and Health Sciences; Department of Urology

Malaysia, Serdang; Serdang; Serdang

M. G. Khairul-Asri

Hospital Serdang; Universiti Putra Malaysia; Hospital Sultan Abdul Aziz Shah UPM

Author for correspondence.
Email: drkhairulasri@gmail.com

Department of Urology; Department of Urology, Faculty of Medicine and Health Sciences; Department of Urology

Malaysia, Serdang; Serdang; Serdang

References

  1. Gujan Garg et al. Unusual complication of prolonged indwelling urinary catheter – iatrogenic hypospadias. J Family Med Prim Care. 2016;5(2):493–494.
  2. Gurwitz J.H. et al. Use of indwelling urinary catheters in nursing homes: implications for quality improvement efforts. J Am Geriatr. Soc. 2016;64: 2204–2209.
  3. Becker В. et al. Iatrogenic hypospadias classification: A new way to classify hypospadias caused by long-term catheterization. Int J Urol 2018;25(11):980–981.
  4. Barnes-Snow Е. et al. Penile laceration from a Foley catheter. J Am Geriatric Soc. 1985;33:712–714.
  5. Larsen T., Hansen B.J. Longitudinal cleavage of the penis, a rare complication seen in paraplegic patients. Int Urol Nephrol. 1989;21:313–316.
  6. Ozbey Н. et al. A closer look at iatrogenic hypospadias A closer look at iatrogenic hypospadias. Andrologia. 2021;53(1): e13803.
  7. Andrews H.O. et al. Iatrogenic hypospadias – A preventable injury? Spinal Cord. International Society of Paraplegia. 1998;36(3):177–180.
  8. Ami Lal Bhat et al. Catheter-induced urethral injury and tubularized urethral plate urethroplasty in such iatrogenic hypospadias. African Journal of Urology. 2020;26:17.
  9. Ozturk H. Iatrogenic hypospadias repair caused by long-term catheterization in a patient with neurogenic bladder: A case report. Pediatr Urol Case Rep. 2019;6(5):111–113.

Supplementary files

Supplementary Files
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1. JATS XML
2. Figure 1. Classification of Iatrogenic Hypospadias (Becker et al 2018)

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3. Figure 2. Initial appearance of iatrogenic hypospadias

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4. Figure 3. Proximal penile hypospadias with 4-cm defect

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5. Figure 4. Buccal Mucosa Graft sutured to the urethral plate at 1st stage

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6. Figure 5. Second stage of hypospadias repair

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7. Figure 6. 3-month follow-up

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