#0401

Where Do We Stand with Hyperbaric Oxygen Therapy in Hypospadias, A Review of the Literature

Y. Kuo^1,2

¹National Cheng Kung University Hospital Dou-Liou Branch, Division of Urology, Department of Surgery, Yunlin county, Taiwan
²National Cheng Kung University Hospital, Department of Urology, Tainan city, Taiwan

Introduction:

Hypospadias surgery is often associated with unfavorable outcomes, such as fistula formation and tissue contracture. While various procedures exist for hypospadias repair, complication rates range from 4% to 27%, depending on the approach. Re-operations for complex cases after failed repairs pose even greater challenges for urologists, with an even higher risk of complications. Hyperbaric oxygen therapy (HBOT) is widely recognized for its role in promoting tissue healing in chronic wounds. This study aims to evaluate the utility and safety of HBOT in patients undergoing hypospadias treatment.

Material and methods:

Systematic research was conducted in PubMed using the keywords “hyperbaric oxygen therapy” and “hypospadias.” The primary outcomes included the incidence of complications and graft failure, while the secondary outcomes included the side effects of HBOT.

Results:

Four non-randomized original studies were identified as relevant to our topic. These studies mainly explored the application of HBOT in complex, re-operative hypospadias cases. The standard HBOT protocol included 10 sessions starting on postoperative day 1, with 100% oxygen exposure at 2–2.4 atm for 90–130 minutes per session. Furthermore, Bush et al. implemented a protocol of 20 HBOT sessions before conducting tubularized autograft repair using oral mucosa. All four studies demonstrated that HBOT significantly reduced complication rates following hypospadias surgery, particularly by decreasing graft contracture and graft failure rates. Although claustrophobia was noted as a possible concern during HBOT, no significant side effects were reported in any of the studies.