The Effectiveness of Adjuvant Hyperbaric Oxygen Therapy in Adults who Underwent Hypospadias Surgery

Abstract

Aim: To evaluate the role of hyperbaric oxygen therapy (HBO2T) with buccal mucosal tube urethroplasty in adult patients with hypospadias. Material and Method: Sixteen adult patients with hypospadias were included in our study. Patients with a short urethra and penile curvature were treated in two stages (orthoplasty+ buccal mucosal tube urethroplasty). Buccal mucosa was taken and prepared for tube urethroplasty around a 16 French (Fr) nelaton catheter and the urethral tube was introduced between the urethral meatus and glans penis. Beginning the 1st postoperative day (HBO2T) was applied for 10 sessions during weekdays in 13 patients. Results: The mean age was 21 (+/- 1.23) years and mean follow-up time was 10.1 (+/- 2.1) months. In the group who received HBO2T postoperatively (n= 13), a two-stage (orthoplasty+ buccal mucosal tube urethroplasty) procedure was performed in 6 (46%), and the mean length of graft was 5.4 (+/- 1.23) cm. In this group of 13 the success rate without any additional manipulations (urethrotomy intern, fistula repair) was 54% (7/ 13). After additional manipulations, complete healing was achieved in 11 out of 13 patients (84.6%). In the group who did not receive HBO2T postoperatively (n= 3), a two-stage procedure was performed in 1 patient (33%), and the mean length of graft was 8 (+/- 5) cm. In this group of 3, complete healing was not achieved in any of these patients as a result of the hypospadias surgery. However, after the additional manipulations, complete healing was achieved in 1 patient (33%). Discussion: Given the promising rates of surgical success, postoperative HBO2T might be considered as a supportive treatment modality for adult patients with hypospadias who undergo buccal mucosal tube urethroplasty. Randomized controlled studies are needed.