Impact of patient age on distal hypospadias repair: A surgical perspective

Perlmutter, Adam E.; Morabito, Rocco; Tarry, William F.

doi:10.1016/j.urology.2006.03.079

Cited by 65 publications

(33 citation statements)

References 19 publications

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“…The age at repair, severity of hypospadias, complexity of the repair techniques, surgeon expertise and the variable wound-healing capacity of the penile tissue appear to be important factors determining the outcome of repair 6. International guidelines recommend repair between 6 and 18 months of age;7 however, some studies have found no difference in outcomes based on the age at the time of repair,8 while others have reported fewer complications following repairs performed before 1 year 9. Depending on the severity and technique, reoperation rates can range from 4% to 35%,10 and one study found an average of five additional procedures required to achieve satisfactory results after a failed repair 11.…”

Section: Introductionmentioning

confidence: 99%

Prevalence, repairs and complications of hypospadias: an Australian population-based study

et al. 2015

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Objective: To investigate hypospadias prevalence and trends, rate of surgical repairs and postrepair complications in an Australian population.Methods: Hypospadias cases were identified from all live born infants in New South Wales, Australia, 2001-2010 using routinely collected birth and hospital data. Prevalence, trends, surgical procedures or repairs, hospital admissions and complications following surgery were evaluated. Risk factors for re-operation and complications were assessed using multivariate logistic regression.Results: There were 3,186 boys with hypospadias in 2001-2010. Overall prevalence was 35.1 per 10,000 livebirths and remained constant during the study period. Proportions of anterior, middle, proximal and unspecified hypospadias were 41.3%, 26.2%, 5.8% and 26.6%, respectively. Surgical procedures were performed in 1,945 (61%) boys, with 1,718 primary repairs. The overall post-surgery complication rate involving fistulas or strictures was 13%, but higher (33%) for proximal cases. Complications occurred after one year post-repair in 52.3% of cases and up to five years. Boys with proximal or middle hypospadias were at increased risk of re-operation or complications, but age at primary repair did not affect the outcome. Conclusions:One in 285 infants were affected with hypospadias, 60% required surgical repair or correction and one in eight experienced complications. The frequency of late complications would suggest that clinical review should be maintained for more than one year post-repair.

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Section: Introductionmentioning

confidence: 99%

Prevalence, repairs and complications of hypospadias: an Australian population-based study

et al. 2015

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“…The publications for each procedure are included in Table-2, along with the corresponding publication date, number of patients, and patient accrual period, when available (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Resultsmentioning

confidence: 99%

Complications rates of non-oncologic urologic procedures in population-based data: a comparison to published series

et al. 2010

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Purpose: Published single institutional case series are often performed by one or more surgeons with considerable expertise in specific procedures. The reported incidence of complications in these series may not accurately reflect community-based practice. We sought to compare complication and mortality rates following urologic procedures derived from populationbased data to those of published single-institutional case series. Materials and Methods:In-hospital mortality and complications of common urologic procedures (percutaneous nephrostomy, ureteropelvic junction obstruction repair, ureteroneocystostomy, urethral repair, artificial urethral sphincter implantation, urethral suspension, transurethral resection of the prostate, and penile prosthesis implantation) reported in the U.S.'s National Inpatient Sample of the Healthcare Cost and Utilization Project were identified. Rates were then compared to those of published single-institution series using statistical analysis. Results: For 7 of the 8 procedures examined, there was no significant difference in rates of complication or mortality between published studies and our population-based data. However, for percutaneous nephrostomy, two published single-center series had significantly lower mortality rates (p < 0.001). The overall rate of complications in the population-based data was higher than published single or select multi-institutional data for percutaneous nephrostomy performed for urinary obstruction (p < 0.001). Conclusions: If one assumes that administrative data does not suffer from under reporting of complications then for some common urological procedures, complication rates between population-based data and published case series seem comparable. Endorsement of mandatory collection of clinical outcomes is likely the best way to appropriately counsel patients about the risks of these common urologic procedures.

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“…The difficulties with neonatal surgery in this subregion led to deferment of surgery for those who presented during the neonatal period but required general anesthesia until a minimum age of 6 months [19], unlike in developed centers with facilities for neonatal operations [1,2,6]. Therefore, only children with glanular and subcoronal hypospadias who did not require general anesthesia were repaired during the neonatal period.…”

Section: Discussionmentioning

confidence: 99%

“…The worsening of ventral chordee of the hypospadic penis, especially the posterior types, during erection results in a more posteriorly displaced external urethral meatus which leads to difficulty in penetration and external ejaculation of semen during sexual intercourse [1]. Also, delayed repair after the age of awareness has been reported as a cause of psychological impotence in affected males due to associated traumatic effects, and better results have been achieved by earlier authors [1,2], when repair was done at a younger age (before awareness or under 5 years). Although delayed presentation is rampant with many congenital anomalies, previous workers [3,4] have noted that children with hypospadias present early in this subregion, making early repair being advocated worldwide appear feasible.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hypospadias repair in a resource-poor region: Coping with the challenges in 5 years

Osifo

Mene

2010

Journal of Pediatric Urology

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Impact of patient age on distal hypospadias repair: A surgical perspective

Cited by 65 publications

References 19 publications

Prevalence, repairs and complications of hypospadias: an Australian population-based study

Prevalence, repairs and complications of hypospadias: an Australian population-based study

Complications rates of non-oncologic urologic procedures in population-based data: a comparison to published series

Hypospadias repair in a resource-poor region: Coping with the challenges in 5 years

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