Marco Bandini1,2, Sasha Sekulovic3, Bogdan Spiridonescu3, Pramod Krishnappa4, Anuj Deep Dangi5, Milan Slavkovic3, Vladislav Pesic3, Andrea Salonia6, Alberto Briganti6, Francesco Montorsi6, Rados Djinovic3. 1. Sava Perovic Foundation, Center for Genito-Urinary Reconstructive Surgery, Belgrade, Serbia. bandini.marco@hsr.it. 2. Unit of Urology, Urological Research Institute (URI), IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, MI, Italy. bandini.marco@hsr.it. 3. Sava Perovic Foundation, Center for Genito-Urinary Reconstructive Surgery, Belgrade, Serbia. 4. Department of Urology, NU Hospitals, Bangalore, India. 5. Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India. 6. Unit of Urology, Urological Research Institute (URI), IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, MI, Italy.
Abstract
PURPOSE: Penile curvature (PC) is a common component of hypospadias, but its presence is inconstantly assessed. We aim to report prevalence of PC in hypospadias patients, as well as to report our method to assess and correct PC, with the associated postoperative outcomes. METHODS: We scrutinized 303 pediatric hypospadias patients operated (2013-2018) at our referral center. PC was routinely assessed and eventually corrected with dorsal plications (DP) as one-stage procedure, or ventral tunica attenuations ± DP as two-stage repair. PC severity and surgical treatment of PC were compared between primary and failed hypospadias. Finally, PC severity, failed repair and PC treatment were tested as predictors of perioperative complications. RESULTS: PC (> 10°) was identified in 274/303 (90.4%) patients, 86.1% with distal, 91.8% with midshaft, and 100% with proximal hypospadias, respectively. PC was found in 51/64 (79.7%) of failed hypospadias. One-stage and two-stage procedures were adopted in 211/274 (77%) and 63/274 (23%) children, respectively. PC severity (p = 0.1) and PC treatment (p = 0.4) did not differ between primary and failed hypospadias. PC severity (all p > 0.2), failed repair (p = 0.8), and PC treatment (all p > 0.09) were not predictors of perioperative complications. 95.6% of patients achieved a straight penis. CONCLUSION: Less than 1/10 patients did not require PC correction. High rate of residual PC in failed hypospadias and similar severity between failed and primary suggest that PC was usually under-corrected. It is possible to correct PC completely and the resulting complication would not be associated with PC severity, failed repair or treatment adopted.
PURPOSE: Penile curvature (PC) is a common component of hypospadias, but its presence is inconstantly assessed. We aim to report prevalence of PC in hypospadiaspatients, as well as to report our method to assess and correct PC, with the associated postoperative outcomes. METHODS: We scrutinized 303 pediatric hypospadiaspatients operated (2013-2018) at our referral center. PC was routinely assessed and eventually corrected with dorsal plications (DP) as one-stage procedure, or ventral tunica attenuations ± DP as two-stage repair. PC severity and surgical treatment of PC were compared between primary and failed hypospadias. Finally, PC severity, failed repair and PC treatment were tested as predictors of perioperative complications. RESULTS: PC (> 10°) was identified in 274/303 (90.4%) patients, 86.1% with distal, 91.8% with midshaft, and 100% with proximal hypospadias, respectively. PC was found in 51/64 (79.7%) of failed hypospadias. One-stage and two-stage procedures were adopted in 211/274 (77%) and 63/274 (23%) children, respectively. PC severity (p = 0.1) and PC treatment (p = 0.4) did not differ between primary and failed hypospadias. PC severity (all p > 0.2), failed repair (p = 0.8), and PC treatment (all p > 0.09) were not predictors of perioperative complications. 95.6% of patients achieved a straight penis. CONCLUSION: Less than 1/10 patients did not require PC correction. High rate of residual PC in failed hypospadias and similar severity between failed and primary suggest that PC was usually under-corrected. It is possible to correct PC completely and the resulting complication would not be associated with PC severity, failed repair or treatment adopted.
Entities:
Keywords:
Chordee; Hypospadias; Pediatric urology; Penile curvature; Referral Center
Authors: Marco Bandini; Guido Barbagli; Riccardo Leni; Giuseppe O Cirulli; Giuseppe Basile; Sofia Balò; Francesco Montorsi; Salvatore Sansalone; Andrea Salonia; Alberto Briganti; Denis Butnaru; Massimo Lazzeri Journal: World J Urol Date: 2021-04-15 Impact factor: 4.226