Hypospadias: clinical approach, surgical technique and long-term outcome

Hypospadias: clinical approach, surgical technique and long-term outcome

Background Hypospadias is one of the most common congenital abnormalities in male newborn. There is no universal approach to hypospadias surgical repair, with more than 300 corrective procedures described in current literature. The reoperation rate within 6-12 months of the initial surgery is most f...

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Published in:BMC pediatrics Vol. 21; no. 1; pp. 1 - 523
Main Authors: Ceccarelli, Pier Luca, Lucaccioni, Laura, Poluzzi, Francesca, Bianchini, Anastasia, Biondini, Diego, Iughetti, Lorenzo, Predieri, Barbara
Format: Journal Article
Language:English
Published: London BioMed Central Ltd 26-11-2021
BioMed Central
BMC
Subjects:
Age
Care and treatment
Child development
Children & youth
Families & family life
Genitourinary organs
Hypospadias
Long term outcome
Parents & parenting
Patient outcomes
Patients
Pediatric research
Pediatrics
Penis
Population
Questionnaires
Response rates
Surgeons
Surgery
Surgical outcomes
Surgical techniques
Teenagers
Young adults
Italy
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Summary:Background Hypospadias is one of the most common congenital abnormalities in male newborn. There is no universal approach to hypospadias surgical repair, with more than 300 corrective procedures described in current literature. The reoperation rate within 6-12 months of the initial surgery is most frequently used as an outcome measure. These short-term outcomes may not reflect those encountered in adolescence and adult life. This study aims to identify the long-term cosmetic, functional and psychosexual outcomes. Methods Medical records of boys who had undergone surgical repair of hypospadias by a single surgical team led by the same surgeon at a single centre between August 2001 and December 2017 were reviewed. Families were contacted by telephone and invited to participate. Surgical outcome was assessed by combination of clinical examination, a life-related interview and 3 validated questionnaires (the Penile Perception Score-PPS, the Hypospadias Objective Score Evaluation-HOSE, the International Index of Erectile Function-5-IIEF5). Outcomes were compared according to age, severity of hypospadias, and respondent (child, parent and surgeon). Results 187 children and their families agreed to participate in the study. 46 patients (24.6%) presented at least one complication after the repair, with a median elapsed time of 11.5 months (6.5-22.5). Longitudinal differences in surgical corrective procedures (p < 0.01), clinical approach (p < 0.01), hospitalisation after surgery (p < 0.01) were found. Cosmetic data from the PPS were similar among children and parents, with no significant differences in child's age or the type of hypospadias: 83% of children and 87% of parents were satisfied with the cosmetic result. A significant difference in functional outcome related to the type of hypospadias was reflected responses to HOSE amongst all groups of respondents: children (p < 0.001), parents (p=0.02) and surgeon (p < 0.01). The child's HOSE total score was consistently lower than the surgeon (p < 0.01). The HOSE satisfaction rate on functional outcome was 89% for child and 92% for parent respondents. Conclusion Surgeons and clinicians should be cognizant of the long-term outcomes following hypospadias surgical repair and this should be reflected in a demand for a standardised approach to repair and follow-up. Keywords: Hypospadias, Long term outcome, Surgery
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ISSN:1471-2431
1471-2431
DOI:10.1186/s12887-021-02941-4