TY - JOUR
T1 - Outcomes of Delayed Hypospadias Repair
T2 - Implications for Decision Making
AU - Dodson, Jennifer L.
AU - Baird, Andrew D.
AU - Baker, Linda A.
AU - Docimo, Steven G.
AU - Mathews, Ranjiv I.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2007/7
Y1 - 2007/7
N2 - Purpose: The current American Academy of Pediatrics recommendation is to perform hypospadias repair at age 6 to 12 months. Primary hypospadias repair at adolescence or beyond is uncommon, and there is little reported about the postoperative course of such patients. We report the outcomes for a series of patients who underwent primary hypospadias repair at age 10 years or older. Materials and Methods: We identified patients seen at our institution between 1979 and 2002 who underwent primary hypospadias repair at age 10 years or older. Electronic and paper charts were abstracted for baseline demographics, degree of hypospadias, surgical technique, complications and reoperation. Results: A total of 31 patients were identified, with a median available followup of 14 months. Median patient age at first hypospadias surgery was 13 years. The location of the urethral meatus was distal in 19 patients, mid shaft in 7, proximal in 4 and undetermined in 1. A variety of techniques were used, including meatal advancement and glanuloplasty, meatal based flaps, island onlay flaps, Snodgrass repair and staged procedures. Complications were noted in 48% of patients (15 of 31), including fistula (10), stricture (4), hematoma (2) and other complications (2). Conclusions: Although retrospective in nature, these data suggest that delay of primary hypospadias repair into the teen years or beyond may result in more complications than currently accepted for infant hypospadias repair.
AB - Purpose: The current American Academy of Pediatrics recommendation is to perform hypospadias repair at age 6 to 12 months. Primary hypospadias repair at adolescence or beyond is uncommon, and there is little reported about the postoperative course of such patients. We report the outcomes for a series of patients who underwent primary hypospadias repair at age 10 years or older. Materials and Methods: We identified patients seen at our institution between 1979 and 2002 who underwent primary hypospadias repair at age 10 years or older. Electronic and paper charts were abstracted for baseline demographics, degree of hypospadias, surgical technique, complications and reoperation. Results: A total of 31 patients were identified, with a median available followup of 14 months. Median patient age at first hypospadias surgery was 13 years. The location of the urethral meatus was distal in 19 patients, mid shaft in 7, proximal in 4 and undetermined in 1. A variety of techniques were used, including meatal advancement and glanuloplasty, meatal based flaps, island onlay flaps, Snodgrass repair and staged procedures. Complications were noted in 48% of patients (15 of 31), including fistula (10), stricture (4), hematoma (2) and other complications (2). Conclusions: Although retrospective in nature, these data suggest that delay of primary hypospadias repair into the teen years or beyond may result in more complications than currently accepted for infant hypospadias repair.
KW - hypospadias
KW - outcome assessment (health care)
KW - postoperative complications
KW - urologic surgical procedures
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U2 - 10.1016/j.juro.2007.03.055
DO - 10.1016/j.juro.2007.03.055
M3 - Article
C2 - 17499776
AN - SCOPUS:34250176578
SN - 0022-5347
VL - 178
SP - 278
EP - 281
JO - Journal of Urology
JF - Journal of Urology
IS - 1
ER -