To determine which form of urinary diversion is most effective for each type of hypospadias, we polled all full-time practicing pediatric urologists in the United States and Canada. Each was asked to complete a questionnaire, specifying the method of urinary diversion used, based on the severity of the hypospadias. Ninety-eight percent (84 of 86) of the urologists contacted replied to the survey. Our findings suggest that: (1) Urinary diversion is usually not necessary for very mild types of hypospadias. (2) Intraurethral drainage is the preferred form of diversion for moderate types of hypospadias. (3) Suprapubic drainage with an intraurethral stent is the favored means of diversion for severe types of hypospadias. (4) Perineal urethrostomy is rarely used today in hypospadias surgery.
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