Management of Urethral Hair Following Urethral Reconstruction: A Systematic Review for Evidence Synthesis.

INTRODUCTION

Urethral hair is a rare but significant issue in cases of severe hypospadias, typically after using hair-bearing skin grafts. This can cause early and late complications, including urinary obstruction, infections, and stone formation. Prevention is the key, favoring nonhair-bearing grafts. If hair-bearing skin is used, hair removal techniques are employed. Managing complications may require surgical interventions such as endoscopic hair removal or repeat urethroplasty. Without available literature, this systematic review, elaborating and comparing various management techniques for urethral hair, attempts to generate evidence for managing such pertinent clinical scenario.

MATERIALS AND METHODS

PubMed, SCOPUS, Embase, and Web of Science databases were explored, and relevant studies were selected. Data were extracted to study the bibliographic information of each article, the number of patients in each article, the age of patients, primary diagnosis, the method used to manage the urethral hair, the number of times the procedure was repeated for satisfactory results, and total follow-up duration before reporting the results.

RESULTS

A systematic review identified 80 articles, 16 eligible for full-text review, including 14 case reports and two original articles, covering 41 male patients treated from 1977 to 2023, with substantial agreement on study quality assessment among the observers. Most cases ( = 37/41) involved hypospadias follow-ups, with laser-based hair removal being the primary treatment ( = 32/41 patients). Various lasers, such as neodymium-doped yttrium aluminum garnet and carbon dioxide, were used, and a median of one procedure was needed.

CONCLUSION

Managing urethral hair posthypospadias repair requires laser treatments and continuous follow-up to prevent complications and ensure success.