SOC
Surgery on Children

Surgery on Children Journal aims to publish issues related to Pediatric Surgery, Pediatric Neurosurgery, Pediatric Plastic Surgery, Pediatric Cardiovascular Surgery, Pediatric Orthopedic Surgery, Pediatric Vascular Surgery, Pediatric Gynecology and Obstetrics, Pediatric Ear Nose Throat, Ophthalmology, Pediatric Anesthesiology and Reanimation, Pediatric Urology, Pediatric Surgical Intensive Care Clinic, and other clinical surgery fields on children of the highest scientific and clinical value at an international level and accepts articles on these topics.

eISSN: 3023-7289
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Case Report
Delayed diagnosis of distal urethral stricture after hypospadias repair in a child: the critical role of physical examination in preventing irreversible renal damage
Abstract
We present a pediatric case of distal urethral stricture following hypospadias repair, in which prolonged misattribution of lower urinary tract symptoms to functional causes led to delayed diagnosis and irreversible renal damage. A 12-year-old boy with a history of hypospadias repair in infancy presented with urinary incontinence, incomplete bladder emptying, and nocturia. He had previously undergone multiple pharmacologic treatments without improvement. Physical examination revealed a narrowed coronal meatus. Ultrasonography demonstrated bilateral hydronephrosis and bladder wall thickening, while uroflowmetry showed a plateau-shaped curve with severe obstruction. Intraoperatively, the meatus could only be passed with a 4-Fr tube. Because the meatus was at the coronal level, a dorsal plate incision was extended to the glans tip, providing an adequate flap for tubularized incised plate urethroplasty (TIPU). No graft was required. Postoperatively, uroflowmetry normalized and hydronephrosis regressed, but dimercaptosuccinic acid (DMSA) scintigraphy revealed bilateral renal scars. This case highlights the importance of physical examination and uroflowmetry in the long-term follow-up of children after hypospadias repair, as timely recognition of meatal or urethral obstruction can prevent irreversible upper urinary tract damage.

Keywords : Hypospadias repair, urethroplasty, urethral stricture, hydronephrosis, physical examination

Download Article


1. Simonnet H, Lallemant-Dudek P. Urinary incontinence in children. Rev Prat. 2024;74(2):179-184.
2. Wu Y, Wang J, Zhao T, et al. Complications following primary repair of non-proximal hypospadias in children: a systematic review and meta-analysis. Front Pediatr. 2020;8:579364. doi:10.3389/fped.2020.579364
3. Radmayr C, Bogaert G, Bujons A, et al. EAU Guidelines on Paediatric Urology. Arnhem, The Netherlands: European Association of Urology; 2025. Available at: https://uroweb.org/guidelines/paediatric-urology. Accessed September 11, 2025.
4. González R, Ludwikowski BM. Importance of urinary flow studies after hypospadias repair: a systematic review. Int J Urol. 2011;18(11):757-761. doi:10.1111/j.1442-2042.2011.02839.x
5. Boroda J, Gitlin J, Fang A, et al. A comparison of 467 uroflowmetry results in repaired hypospadias vs. normal male flows. J Pediatr Urol. 2024;20(4):690.e1-690.e7. doi:10.1016/j.jpurol.2024.04.017
6. Andersson M, Doroszkiewicz M, Arfwidsson C, et al. Normalized urinary flow at puberty after tubularized incised plate urethroplasty for hypospadias in childhood. J Urol. 2015;194(5):1407-1413. doi:10.1016/j.juro.2015.06.072
7. Van der Horst H, De Wall L, Toelen J. Hypospadias, all there is to know. Eur J Pediatr. 2017;176(3):435-441. doi:10.1007/s00431-017-2864-5
8. Hueber PA, Antczak C, Abdo A, et al. Long-term functional outcomes of distal hypospadias repair: a single center retrospective comparative study of TIPs, Mathieu and MAGPI. J Pediatr Urol. 2015;11(2):68.e1-68.e7. doi:10.1016/j.jpurol.2014.09.011
9. Snodgrass WT, Bush N, Cost N. Tubularized incised plate hypospadias repair for distal hypospadias. J Pediatr Urol. 2010;6(4):408-413. doi:10. 1016/j.jpurol.2009.09.010
10. Silay MS, ‘t Hoen L, Bhatt N, et al. Are there any benefits of using an inlay graft in the treatment of primary hypospadias in children? A systematic review and metanalysis. J Pediatr Urol. 2021;17(3):303-315. doi:10.1016/j.jpurol.2021.02.013
Article available in :
Volume 3, Issue 2, 2026
Page : 54-56
https://doi.org/10.51271/SOC-0069
Article Information
Received : 13 Ağu 2025
Accepted : 12 Eyl 2025
Published : 27 Nis 2026
Corresponding Author :

Hasan Turan: Department of Pediatric Urology, Çiğli Regional Training and Research Hospital, İzmir, Turkiye

[email protected]
Citation : Turan H, Kuas N. Delayed diagnosis of distal urethral stricture after hypospadias repair in a child: the critical role of physical examination in preventing irreversible renal damage. Surg Child. 2026;3(2):54-56. doi:10.51271/SOC-0069

Read: 66
Download : 128
Cited: 0
_Footer