Literature DB >> 27840122

Intermediate-Term Followup of Proximal Hypospadias Repair Reveals High Complication Rate.

Christopher J Long1, David I Chu2, Robert W Tenney2, Andrew R Morris2, Dana A Weiss2, Aseem R Shukla2, Arun K Srinivasan2, Stephen A Zderic2, Thomas F Kolon2, Douglas A Canning2.   

Abstract

PURPOSE: Results following distal hypospadias repair are favorable. Grouping proximal and distal hypospadias repair artificially increases the perceived success rate of proximal hypospadias. We identified our complication rate of proximal hypospadias repair and hypothesized a higher complication rate for 1-stage repair.
MATERIALS AND METHODS: We retrospectively reviewed the records of consecutive boys who underwent proximal hypospadias from 2007 to 2014. Proximal hypospadias was defined as a urethral meatus location at or more proximal than the penoscrotal junction after penile degloving. We further stratified boys into those with planned 1-stage vs 2-stage repair. Univariate and Cox regression analyses were performed to assess associations with covariates and compare time to the first complication, respectively.
RESULTS: A total of 167 boys met study inclusion criteria. Median followup was 31.7 months for 1-stage repair in 86 patients and staged repair in 81. The overall complication rate was 56%. Complications developed in 53 of 86 1-stage (62%) vs 40 of 81 staged (49%) repairs (p = 0.11). The number of unplanned procedures per patient was higher in the 1-stage than in the staged group (0.99 vs 0.69, p = 0.06), as was the number of patients who had at least 2 complications (29 of 86 or 33% vs 13 of 81 or 16%, p = 0.03). Cox regression showed no difference in time to the first complication for staged compared to 1-stage repair (HR 0.77, 95% CI 0.43-1.39).
CONCLUSIONS: Our 56% complication rate of proximal hypospadias warrants further long-term patient followup. More patients in the 1-stage group experienced at least 2 complications. However, when complications developed, they developed no differently in the 2 groups.
Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  hypospadias; male; postoperative complications; reconstructive surgical procedures; urethra

Mesh:

Year:  2016        PMID: 27840122      PMCID: PMC5462455          DOI: 10.1016/j.juro.2016.11.054

Source DB:  PubMed          Journal:  J Urol        ISSN: 0022-5347            Impact factor:   7.450


  25 in total

1.  Impact of patient age on distal hypospadias repair: a surgical perspective.

Authors:  Adam E Perlmutter; Rocco Morabito; William F Tarry
Journal:  Urology       Date:  2006-09-18       Impact factor: 2.649

2.  Primary severe hypospadias: comparison of reoperation rates and parental perception of urinary symptoms and cosmetic outcomes among 4 repairs.

Authors:  Marco Castagnetti; Evisa Zhapa; Waifro Rigamonti
Journal:  J Urol       Date:  2012-11-12       Impact factor: 7.450

3.  Hypospadias repair with onlay preputial graft: a 25-year experience with long-term follow-up.

Authors:  Gina M Cambareri; Michael Yap; George W Kaplan
Journal:  BJU Int       Date:  2016-02-17       Impact factor: 5.588

4.  Hypospadias anatomy: Elastosonographic evaluation of the normal and hypospadic penis.

Authors:  Francesco Saverio Camoglio; Costanza Bruno; Silvia Zambaldo; Nicola Zampieri
Journal:  J Pediatr Urol       Date:  2016-02-23       Impact factor: 1.830

5.  Complications following Staged Hypospadias Repair Using Transposed Preputial Skin Flaps.

Authors:  Irina Stanasel; Hoang-Kim Le; Aylin Bilgutay; David R Roth; Edmond T Gonzales; Nicolette Janzen; Chester J Koh; Patricio Gargollo; Abhishek Seth
Journal:  J Urol       Date:  2015-02-17       Impact factor: 7.450

6.  The management of proximal hypospadias using a 1-stage hypospadias repair with a preputial free graft for neourethral construction and a preputial pedicle flap for ventral skin coverage.

Authors:  J A Stock; J Cortez; H C Scherz; G W Kaplan
Journal:  J Urol       Date:  1994-12       Impact factor: 7.450

7.  The split prepuce in situ onlay hypospadias repair.

Authors:  H G Rushton; A B Belman
Journal:  J Urol       Date:  1998-09       Impact factor: 7.450

8.  Is it safe to solely use ventral penile tissues in hypospadias repair? Long-term outcomes of 578 Duplay urethroplasties performed in a single institution over a period of 14 years.

Authors:  C Grosos; R Bensaid; D-B Gorduza; P Mouriquand
Journal:  J Pediatr Urol       Date:  2014-07-22       Impact factor: 1.830

9.  The Pediatric Penile Perception Score: an instrument for patient self-assessment and surgeon evaluation after hypospadias repair.

Authors:  Daniel M Weber; Verena B Schönbucher; Markus A Landolt; Rita Gobet
Journal:  J Urol       Date:  2008-07-18       Impact factor: 7.450

10.  Long-term functional outcomes after penoscrotal hypospadias repair: A retrospective comparative study of proximal TIP, Onlay, and Duckett.

Authors:  Pierre-Alain Hueber; Monica Salgado Diaz; Yann Chaussy; Julie Franc-Guimond; Diego Barrieras; Anne-Marie Houle
Journal:  J Pediatr Urol       Date:  2016-06-02       Impact factor: 1.830

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  23 in total

Review 1.  Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes.

Authors:  Melise A Keays; Sumit Dave
Journal:  Can Urol Assoc J       Date:  2017 Jan-Feb       Impact factor: 1.862

2.  Patients with disorders of sex development and proximal hypospadias are at high risk for reoperation.

Authors:  Amanda F Saltzman; Alonso Carrasco; Alexandra Colvin; Jeffrey B Campbell; Vijaya M Vemulakonda; Duncan Wilcox
Journal:  World J Urol       Date:  2018-05-31       Impact factor: 4.226

Review 3.  Surgical management of primary severe hypospadias in children: an update focusing on penile curvature.

Authors:  Marco Castagnetti; Alaa El-Ghoneimi
Journal:  Nat Rev Urol       Date:  2022-01-17       Impact factor: 14.432

Review 4.  Hypospadias: lessons learned. An overview of incidence, epidemiology, surgery, research, complications, and outcomes.

Authors:  Dan Wood; Duncan Wilcox
Journal:  Int J Impot Res       Date:  2022-03-29       Impact factor: 2.896

5.  Clinical Profiles and Surgical Outcome of Hypospadias Repair at a Teaching Hospital in Ethiopia.

Authors:  Maru Gama; Birhan Abitew; Kirubel Abebe
Journal:  Ethiop J Health Sci       Date:  2022-05

Review 6.  [Hypospadias : Insights and challenges].

Authors:  I Rübben; R Stein
Journal:  Urologe A       Date:  2017-10       Impact factor: 0.639

7.  Association between intra-operative meatal mismatch and urethrocutaneous fistula development in hypospadias repair.

Authors:  Anthony D'Oro; Yvonne Y Chan; Ilina Rosoklija; Theresa Meyer; Rachel Shannon; Emilie K Johnson; Dennis B Liu; Edward M Gong; Max Maizels; Derek J Matoka; Elizabeth B Yerkes; Bruce W Lindgren; Earl Y Cheng; David I Chu
Journal:  J Pediatr Urol       Date:  2020-12-04       Impact factor: 1.830

Review 8.  A meta-analysis comparing dorsal plication and ventral lengthening for chordee correction during primary proximal hypospadias repair.

Authors:  Ramesh Babu; V V S Chandrasekharam
Journal:  Pediatr Surg Int       Date:  2022-01-19       Impact factor: 1.827

9.  Preliminary report: Surgical outcomes following genitoplasty in children with moderate to severe genital atypia.

Authors:  K J Bernabé; N J Nokoff; D Galan; D Felsen; C E Aston; P Austin; L Baskin; Y-M Chan; E Y Cheng; D A Diamond; R Ellens; A Fried; S Greenfield; T Kolon; B Kropp; Y Lakshmanan; S Meyer; T Meyer; A M Delozier; L L Mullins; B Palmer; A Paradis; P Reddy; K J Scott Reyes; M Schulte; J M Swartz; E Yerkes; C Wolfe-Christensen; A B Wisniewski; D P Poppas
Journal:  J Pediatr Urol       Date:  2018-02-02       Impact factor: 1.921

10.  Post-operative complications following masculinizing genitoplasty in moderate to severe genital atypia: results from a multicenter, observational prospective cohort study.

Authors:  Christopher J Long; Jason Van Batavia; Amy B Wisniewski; Christopher E Aston; Laurence Baskin; Earl Y Cheng; Yegappan Lakshmanan; Theresa Meyer; Bradley Kropp; Blake Palmer; Natalie J Nokoff; Alethea Paradis; Brian VanderBrink; Kristy J Scott Reyes; Elizabeth Yerkes; Dix P Poppas; Larry L Mullins; Thomas F Kolon
Journal:  J Pediatr Urol       Date:  2021-02-19       Impact factor: 1.921

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