complications related to posterior hypospadias repair

Background: Proximal hypospadias repair carries high complications rates. single stage is the standard practice for management but sometimes it is not easy to perform single stage for posterior hypospadias and here appears the need for staged surgery in this study we assess the out coms and complications of the most commonly used techniques in Mosul pediatric surgery center at alkhansaa teaching hospital Objective: To assess the results of management of posterior hypospadias by Tubularized incised plate as single stage and staged repair and to knew the most important complications associated with these two procedures. Methods: this is prospective study for forty patients who were admitted to Mosul pediatric surgery center at alkhansaa teaching hospital from October 2011 till October 2013, their age ranged from 9 month to 15 years, five of them were operated before with complete failure, 31 patient operated by single stage Tubularized Incised Plate technique and the other 9 by two stage technique and they were followed for 6-18 months. Results: The total complications rate was (52%) as follow: (7) cases (17.5%) develop meatal stenosis, (4) patients (10%) develop retrusive meatus, No one develops stricture, (10) cases (25%) develop fistula and none of them develop diverticulum, the total complication rate for Single stage TIP technique was (48.3%) the total complication rate of complications for staged surgery was (66.6%). Conclusion: proximal hypospadias repair is very challenging with high complication rate which need a good experience to deal with it. Single stage or multistage procedure can be utilized to repair this type of hypospadias. Most of the published papers has low number of cases in comparison to the anterior type which represent 70_80% of all cases and for that reason may be the great difference in between different centers in the incidence of complications rate.