Unusual complications of hypospadias repair: diagnosis and management

Authors

  • Rama Kishan Saran Department of Surgery, Dr. S. N. Medical College, Jodhpur, Rajasthan, India
  • Kiran Mirdha Department of Gynaecology and Obstetrics, Umaid Hospital and Dr. S. N. Medical College, Jodhpur, Rajasthan, India
  • Sanya Saran Student, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India
  • Rajendra Prasad Takhar Department of Respiratory Medicine, Government Medical College, Kota, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20193926

Keywords:

Epidermal inclusion cyst, penile swelling, smegma stone, urethral calculi

Abstract

Background: Epidermal inclusion cyst, smegma stones and urethral calculi of the penis are rare and may result as a late complication of hypospadias repair. This study reported the presentation and management of these late complications.

Methods: A prospective observational study included male patients aged more than 6 years of age, who had undergone hypospadias repair 3-15 years back and presented with slow growing, non-tender, mobile, firm to hard swelling. Histopathological and radiographic examination were done and surgery was used for management of epidermal inclusion cyst, urethral calculi and smegma stone. Patients were followed up for one year, postoperatively.

Results: Out of 15 patients, two (13.3%), four (26.7%) and nine (60%) patients were diagnosed with smegma stones, epidermal inclusion cyst and urethral calculi, respectively. The median (range) age of patients was 17 (8-30) years. Patients were presented with slow growing, non-tender, mobile swelling measuring from 1 cm x 3 cm to 2 cm x 1.5 cm. The average size of epidermal inclusion cyst, and urethral calculi was 2 cm x 2.5 cm x 1.5 cm, and 2 cm x 3 cm, respectively. Treatment were complete excision of cyst and removal of smegma stones by surgery and urethral calculi by dorsal urethrotomy. All patients had an uneventful postoperative period and were asymptomatic up to one year of follow-up.

Conclusion: Results suggest that these complications can be managed with complete excision and surgical removal and care must be taken while performing the hypospadias repair to avoid these unusual late complications in patients.

References

Suwa M, Takeda M, Bilim V, Takahashi K. Epidermoid cyst of the penis: a case report and review of the literature. Int J Urol. 2000;7(11):431-3.

Unsal A, Cimentepe E, Saglam R. Penile epidermoid cyst in an elderly patient. Int Urol Nephrol. 2002;34(2):229-30.

Kinebuchi Y, Nakayama T, Fujiwara M, Yoneyama T. Epidermoid cyst of the penis: a case report. Nippon Hinyokika Gakkai Zasshi. 2003;94:452-5.

Saini P, Mansoor MN, Jalali S, Sharma A. Penile epidermal inclusion cyst. Indian J Pediatr. 2010; 77(7):815-6.

Okeke LI. Epidermal inclusion cyst as a rare complication of neonatal male circumcision: a case report. J Med Case Rep. 2009;3(1):7321.

Park HJ, Park NC, Park SW, Jern TK, Choi KU. Penile epidermal inclusion cyst: a late complication of penile girth enhancement surgery. J Sex Med. 2008;5(9):2238-40.

Hayashi Y, Yasui T, Kojima Y, Maruyama T, Tozawa K, Kohn K. Management of urethrai calculi associated with hairballs after urethroplasty for severe hypospadias. Int J Urol. 2007;14(2):161-3.

Ozgok Y, Seckin B, Demirci S, Harmankaya C, Erduran D, Sinav A. Surgical treatment of urethral diverticula in men. Scand J Urol Nephrol. 1994; 28(2):207-10.

Singh V, Singh KM, Sinha RJ. Tricholithobezoar: an unusual long-term complication of hypospadias surgery. Urol J. 2010;7(1):15.

Kaviani A, Hosseini J, Vazirnia AR. A huge penile mass which turned out to be an epidermoid inclusion cyst. Urol J. 2009;6(2):135-7.

Papali AC, Alpert SA, Edmondson JD, Maizels M, Yerkes E, Hagerty J, et al. A review of pediatric glans malformations: a handy clinical reference. J Urol. 2008;180(4S):1737-42.

Howe AS, Hanna MK. Management of 220 adolescents and adults with complications of hypospadias repair during childhood. Asian J Urol. 2017;4(1):14-7.

Giambanco A, Pensabene M, Giuffrè M, Cimador M. Epidermal inclusion cyst of the penis after urethroplasty causing an urethro-cutaneous fistula: a first case report. Pediatr Med Chir. 2013;35:288-9.

Guler Y, Tatar Z, Ucpinar B, Erbin A. An epidermal cyst of the penis after distal hypospadias surgery: a case report. J Med Case Rep. 2018; 12(1):378.

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Published

2019-08-27

How to Cite

Saran, R. K., Mirdha, K., Saran, S., & Takhar, R. P. (2019). Unusual complications of hypospadias repair: diagnosis and management. International Journal of Research in Medical Sciences, 7(9), 3440–3443. https://doi.org/10.18203/2320-6012.ijrms20193926

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Section

Original Research Articles