Hypospadias Repair

Hyperbaric Oxygen is used as a valuable adjunct in paediatric patients undergoing revision operations for hypospadias

hypospadias1
hypospadias2
Info for Patients

Hypospadias is a birth defect where the urethra (tube from the bladder that carries urine) isn't formed at the tip of the penis. This can cause problems with urinating, undescended testicles, underdeveloped foreskin and curving of the penis. Surgery is used to correct this defect and sometimes multiple surgeries are required.

At some centres in the world, small clinical trials have shown that HBOT may help outcomes of hypospadias operations, particularly for patients with revision operations.

For patients having hypospadias surgery the improved oxygen levels at the graft site promotes angiogenesis (new blood vessels to grow) and reduces inflammation, which in turn enables faster healing.

We receive referrals from paediatric surgeons who are planning surgery for complex hypospadias cases and we typically give 15 sessions of hyperbaric oxygen therapy over 3 weeks (5 before the surgery and 10 after).

For further details please see our information booklet here and the video below:

Info for Professionals

At this current time we can only receive referrals for complex cases of hypospadias when the patient has undergone multiple failed surgical repairs.

This is a relatively new and evolving indication for hyperbaric oxygen therapy and therefore there is a limited evidence base. A systematic review and meta-analysis by Chua et al. 2022 showed that adjunct use of hyperbaric oxygen can reduce hypospadias repair failure and complication rates, however higher quality evidence is required.

There is an established evidence base for the effect of HBO on compromised grafts and flaps and this has formed the basis of utilisation of HBO in hypospadias patients.

 

References:

Chua ME, Kim JJK, Ming JM, De Jesus MJ, See MC 4th, Bagli DJ, Rickard M, Koyle MA, Lorenzo AJ. The utilization of hyperbaric oxygenation therapy in hypospadias repair: a systematic review and meta-analysis. Int Urol Nephrol. 2022 Feb;54(2):273-285. doi: 10.1007/s11255-021-03096-y. Epub 2022 Jan 13. PMID: 35024997.

Mathieu D, Marroni A, Kot J. Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. Diving Hyperb Med. 2017 Mar;47(1):24-32. doi: 10.28920/dhm47.1.24-32. Erratum in: Diving Hyperb Med. 2017 Jun;47(2):131-132. doi: 10.28920/dhm47.2.131-132. PMID: 28357821; PMCID: PMC6147240.

Neheman A, Rappaport YH, Verhovsky G, Bush N, Snodgrass W, Lang E, Zisman A, Efrati S. Hyperbaric oxygen therapy for pediatric "hypospadias cripple"-evaluating the advantages regarding graft take. J Pediatr Urol. 2020 Apr;16(2):163.e1-163.e7. doi: 10.1016/j.jpurol.2020.01.002. Epub 2020 Jan 14. PMID: 32171667.

Tanaka HL, Rees JR, Zhang Z, Ptak JA, Hannigan PM, Silverman EM, Peacock JL, Buckey JC; Multicenter Registry for Hyperbaric Oxygen Treatment Consortium. Emerging Indications for Hyperbaric Oxygen Treatment: Registry Cohort Study. Interact J Med Res. 2024 Aug 20;13:e53821. doi: 10.2196/53821. PMID: 39078624; PMCID: PMC11372337.

 

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