How age affects the risk of complications in hypospadias surgery

Abstract Introduction Hypospadias, a common congenital penile anomaly, is typically repaired surgically during early childhood. Postoperative complications, such as urethrocutaneous fistula, remain a significant concern. This study aimed to evaluate the effect of age on postoperative complications in children undergoing distal hypospadias repair. Methods This prospective follow-up study included 60 children with distal hypospadias who underwent surgical correction between October 2023 and July 2024. Participants were divided into two groups: Group A (younger than 18 months) and Group B (older than 18 months). All patients underwent TIP (Tubularized Incised Plate) repair with a dartos flap. Postoperative complications, including urethrocutaneous fistula, yellow granulation tissue, and skin dehiscence, were assessed at catheter removal, 1 and 3 months postoperatively. Results Group A had a significantly shorter mean operation duration compared to Group B (62.88 ± 13.6 min vs. 73.1 ± 17.8 min, p < 0.001). The incidence of urethrocutaneous fistula was significantly lower in Group A (18.5%) compared to Group B (24.2%, p = 0.04). No significant differences were observed between the groups regarding other complications. Conclusion Early surgical correction of distal hypospadias in children under 18 months is associated with reduced incidence of urethrocutaneous fistula and shorter operative times, supporting early intervention.