The passad and present of hypospadias

Abstract

Abstrat: Objective: To review the recent publications of reconstructive techniques of hypospadias a surgery, analyzing their results, correlating them with the variety of existing clinical presentations. Material and methods: Bibliographical study using the systems LILACS, MEDLINE and PUBMED, researching treatments for hypospodias, with preference given to recent advances. Results: In the publications evaluated, the following variations were shown to be the factors that influenced the choice of technique to be used and its results: topography of the meatus; presence of the “chordee”, age at surgery, presence of prior surgery, pre-operatory use of testosterone, presence of urinary derivation. Conclusions: Surgical treatment of hypospadias should be individualized according to the following findings: presence of the “chordee”, topography of the urethral meatus; presence of urethral plate and sufficient adjacent tissue for reconstruction, first surgery or re-intervention, clinical presentation with penile-scrotal transposition. Recent advances in hypospadias surgeries allow us to reinforce the indication of the Snodgrass surgical technique for distal and virgin forms of treatment, ventral onlay buccal mucous membrane; multi-operated complex forms and dorsal buccal mucous membrane in the 3x1 procedure for reconstruction of the urethral plate in primary scrotal and perianal associated with intense ventral curvature.