HOSE: an objective scoring system for evaluating the results of hypospadias surgery

Holland, A.J.A.; Smith, Grahame; Ross, Fiona; Cass, Danny

doi:10.1046/j.1464-410x.2001.02280.x

Cited by 147 publications

(109 citation statements)

References 19 publications

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“…This was the first instrument to be available to objectively assess the surgical outcome and self-perception after hypospadias repair [15] . The HOSE is a scoring system designed to allow an objective appraisal of the outcome of hypospadias repair, based on evaluating meatal location, meatal shape, urinary stream, straightness of erection, and the presence and complexity of any complicating urethral fistula [16] . A HOSE score of more than 14 is defined as normal anatomical outcome [16] .…”

Section: Discussionmentioning

confidence: 99%

“…The HOSE is a five-point scoring system designed to allow an objective appraisal of the outcome of hypospadias repair, based on evaluating meatal location, meatal shape, urinary stream, straightness of erection, and the presence and complexity of any complicating urethral fistula [8,16,17] . The HOSE questionnaire is designed so that the minimum total score would be 5, corresponding to a lowest score for each variable, to a maximum total of 16, equivalent to the highest score for each variable.…”

Section: Methodsmentioning

confidence: 99%

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Long-Term Functional, Cosmetic and Sexual Outcomes of Hypospadias Correction Performed in Childhood

et al. 2015

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Objective: Hypospadias surgery, especially when performed early in life, may have a significant impact on the urinary and sexual functions in an adult. Because the literature is still limited, this paper assesses long-term functional, cosmetic and sexual results of hypospadias repair performed in childhood. Patients and Methods: The study includes 275 patients older than 12 years treated for a hypospadias by an Onlay, Mathieu, Duplay, or Duckett's technique between January 1990 and December 2000. Flowmetry results were retrospectively obtained from patients' charts. The Paediatric Penile Perception Score (PPPS), the Hypospadias Objective Scoring Evaluation (HOSE) and the IIEF-5 score (when older than 16 years old) questionnaires were used to assess cosmetic and sexual results. The PPPS is designed to assess both penile self-perception with regard to meatus, glans, skin and general appearance. The HOSE is a five-point scoring system designed to allow an objective appraisal of the outcome of hypospadias repair, based on evaluating meatal location, meatal shape, urinary stream, straightness of erection, and the presence and complexity of any complicating urethral fistula. Results: Q_max were within age-adjusted references, independent of the surgical technique, with median (range) Q_max of 18.8 ml/s (range 3-45, n = 136). Patients expressed a high satisfaction for every single item of the penile perception scale (PPPS), with mean values between 2 (satisfied) and 3 (very satisfied). Eighty-two percent were satisfied or very satisfied of the overall evaluation of penile appearance. Eighty-one percent of patients had a normal erectile function (IIEF-5 >22; n = 35/43). Conclusions: Taking into account the limitation of a small number of patients resulting from a low 21% questionnaire's response rate, the results of this study align with previous reports from the literature and confirms that hypospadias repair using standard techniques results in acceptable functional, cosmetic and sexual outcomes. This study highlights the need of developing a set of standard approved outcomes assessments tools for evaluating the long-term impact of hypospadias repair performed in infancy.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Long-Term Functional, Cosmetic and Sexual Outcomes of Hypospadias Correction Performed in Childhood

et al. 2015

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“…However, we do not believe that a child below that age is able to understand the various items that were measured and to judge the appearance of his penis. Satisfaction with the penile appearance during childhood is relevant as it is one of the potential factors that may influence the psychosexual development of boys and can potentially interfere with the healthrelated-quality-of-life of the patients even beyond childhood 10,11 .…”

Section: Discussionmentioning

confidence: 99%

The Pediatric Penile Perception Score: An Instrument for Patient Self-Assessment and Surgeon Evaluation After Hypospadias Repair

et al. 2008

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Descriptive RunningheadThe Pediatric Penile Perception Score: Assessment after hypospadias repair Key WordsHypospadias, outcome assessment, child, surgery 2 Abstract PurposeThe aim of this study is to develop and evaluate an instrument that allows to asses and compare the penile perception of patients, parents and surgeons. Materials and MethodsSeventy-seven boys after hypospadias repair between the ages of 6-17 years were interviewed by a psychologist with a standardized questionnaire regarding their penile self-perception, including the following items: Meatus, glans, skin and general appearance. The Pediatric Penile Perception Score (PPPS) was calculated, consisting of the sum of these four items. The results were compared with a control group of age matched boys after inguinal hernia repair. A parent was asked with a questionnaire to report his son's penile appearance using the PPPS. Fifty-six patients accepted standardized photo documentation and their pictures were sent for evaluation with the PPPS to six blinded urologists. ResultsThe PPPS allowed to assess perception of genitalia by patients, parents and urologists. Statistical analysis of the urologist's PPPS revealed a good interrater reliability (interclass correlation: 0.75-0.88) and stability (r=0.59-0.83). Intercorrelation of the items meatus, glans and skin with the general appearance was good in the boys, parents and urologists form. Hypospadias patients expressed a high satisfaction with their penile appearance that did not significantly differ from age matched controls. However, parents and urologists were less satisfied with the penile appearance than patients themselves. ConclusionsThe PPPS is an evaluated, reliable instrument to assess penile self perception in children after hypospadias repair and to appraise the surgical result by parents and non involved urologists.3

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“…2,3 Only few studies of long-term outcome of hypospadias treatment in terms of voiding, surgical complications, sexual functioning, intimate relationships and cosmetic results have been investigated and contrasting results have been obtained so far. [4][5][6] However, most groups used questionnaires only 7,8 and others described a relatively short follow-up or a small number of patients. 5,6 The aim of our study is to investigate the long-term outcome of urinary and sexual function, cosmesis and the quality of intimate relationships in a series of hypospadias representative of a Mediterranean European country.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6] However, most groups used questionnaires only 7,8 and others described a relatively short follow-up or a small number of patients. 5,6 The aim of our study is to investigate the long-term outcome of urinary and sexual function, cosmesis and the quality of intimate relationships in a series of hypospadias representative of a Mediterranean European country. The main limitations of a surgical correction of hypospadias are represented by the unpredictability of the cosmetic and functional results over time.…”

Section: Introductionmentioning

confidence: 99%

Penile length is a very important factor for cosmesis, function and psychosexual development in patients affected by hypospadias: Results from a long-term longitudinal cohort study

Ciancio

Russo

Innocenti

et al. 2015

Int J Immunopathol Pharmacol

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Few studies of long-term outcome of hypospadias treatment in terms of voiding, surgical complications, sexual functioning, intimate relationships and cosmetic results have been investigated and contrasting results have been obtained so far. The aim of our study is to investigate the long-term outcome of urinary and sexual function, cosmesis and the quality of intimate relationships in a series of hypospadias. In this study, 42 patients who underwent surgery for hypospadias were prospectively followed for 15 years. Medical records provided the hypospadias data, the number of reconstructive operations and the reconstruction technique that was used. Patients underwent physical examination, including penile length measurement and completed International Prostatic Symptoms Score (I-PSS), International Index Of Erectile Function (IIEF 15) and the Penile Perception Score questionnaire (PPPS). Twenty patients agreed to participate in the study. At the enrolment, the median value of HOSE was 13, as regards PPPS, 18/20 (90%) were satisfied, while in 1998 only 80% were satisfied. No significant statistical difference has been reported from the results obtained at enrolment and those obtained at follow-up, in terms of PPPS (P = 0.81), IPSS and IIEF-15. Penile length was 6.5 cm flaccid and 10.5 cm stretched. Our data show how cosmesis, function and psychosexual development for these patients are highly connected to surgical outcome, which is understood to be a decrease in penile size.

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HOSE: an objective scoring system for evaluating the results of hypospadias surgery

Cited by 147 publications

References 19 publications

Long-Term Functional, Cosmetic and Sexual Outcomes of Hypospadias Correction Performed in Childhood

Long-Term Functional, Cosmetic and Sexual Outcomes of Hypospadias Correction Performed in Childhood

The Pediatric Penile Perception Score: An Instrument for Patient Self-Assessment and Surgeon Evaluation After Hypospadias Repair

Penile length is a very important factor for cosmesis, function and psychosexual development in patients affected by hypospadias: Results from a long-term longitudinal cohort study

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