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

Abstract 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...

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Autores principales:	Pier Luca Ceccarelli, Laura Lucaccioni, Francesca Poluzzi, Anastasia Bianchini, Diego Biondini, Lorenzo Iughetti, Barbara Predieri
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Hypospadias Long term outcome Surgery Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/1b32cef7fb5d497790f1330f93b6aefa
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spelling	oai:doaj.org-article:1b32cef7fb5d497790f1330f93b6aefa2021-11-28T12:30:13ZHypospadias: clinical approach, surgical technique and long-term outcome10.1186/s12887-021-02941-41471-2431https://doaj.org/article/1b32cef7fb5d497790f1330f93b6aefa2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12887-021-02941-4https://doaj.org/toc/1471-2431Abstract 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.Pier Luca CeccarelliLaura LucaccioniFrancesca PoluzziAnastasia BianchiniDiego BiondiniLorenzo IughettiBarbara PredieriBMCarticleHypospadiasLong term outcomeSurgeryPediatricsRJ1-570ENBMC Pediatrics, Vol 21, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Hypospadias Long term outcome Surgery Pediatrics RJ1-570
spellingShingle	Hypospadias Long term outcome Surgery Pediatrics RJ1-570 Pier Luca Ceccarelli Laura Lucaccioni Francesca Poluzzi Anastasia Bianchini Diego Biondini Lorenzo Iughetti Barbara Predieri Hypospadias: clinical approach, surgical technique and long-term outcome
description	Abstract 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.
format	article
author	Pier Luca Ceccarelli Laura Lucaccioni Francesca Poluzzi Anastasia Bianchini Diego Biondini Lorenzo Iughetti Barbara Predieri
author_facet	Pier Luca Ceccarelli Laura Lucaccioni Francesca Poluzzi Anastasia Bianchini Diego Biondini Lorenzo Iughetti Barbara Predieri
author_sort	Pier Luca Ceccarelli
title	Hypospadias: clinical approach, surgical technique and long-term outcome
title_short	Hypospadias: clinical approach, surgical technique and long-term outcome
title_full	Hypospadias: clinical approach, surgical technique and long-term outcome
title_fullStr	Hypospadias: clinical approach, surgical technique and long-term outcome
title_full_unstemmed	Hypospadias: clinical approach, surgical technique and long-term outcome
title_sort	hypospadias: clinical approach, surgical technique and long-term outcome
publisher	BMC
publishDate	2021
url	https://doaj.org/article/1b32cef7fb5d497790f1330f93b6aefa
work_keys_str_mv	AT pierlucaceccarelli hypospadiasclinicalapproachsurgicaltechniqueandlongtermoutcome AT lauralucaccioni hypospadiasclinicalapproachsurgicaltechniqueandlongtermoutcome AT francescapoluzzi hypospadiasclinicalapproachsurgicaltechniqueandlongtermoutcome AT anastasiabianchini hypospadiasclinicalapproachsurgicaltechniqueandlongtermoutcome AT diegobiondini hypospadiasclinicalapproachsurgicaltechniqueandlongtermoutcome AT lorenzoiughetti hypospadiasclinicalapproachsurgicaltechniqueandlongtermoutcome AT barbarapredieri hypospadiasclinicalapproachsurgicaltechniqueandlongtermoutcome
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Hypospadias: clinical approach, surgical technique and long-term outcome

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