Impact of patient age on distal hypospadias repair

A surgical perspective

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

    Research output: Contribution to journalArticle

    37 Citations (Scopus)

    Abstract

    Objectives: To assess whether the age at which the initial hypospadias repair is performed influences the complication rate of hypospadias repair. Methods: The records of 325 consecutive patients who underwent initial hypospadias repair were reviewed. The patients with glanular and coronal hypospadias underwent repair with either meatoplasty and glanuloplasty or a glans approximation procedure. Patients with subcoronal hypospadias and penile hypospadias underwent repair with tubularized incised plate urethroplasty. The patients were divided into 6-month age groups, and the complication rates were analyzed by age group using the chi-square test. Results: A total of 325 hypospadias repairs were performed from January 1999 to January 2005 by a single surgeon. Of the 325 cases, 194 tubularized incised plate procedures were performed, 69 meatoplasty and glanuloplasty procedures were performed, and 53 glans approximation procedures were performed. Nine tubularized island flap urethroplasties performed for penoscrotal hypospadias were excluded because we did not perform a significant number of proximal urethroplasties. Nineteen patients (6.0%) developed urethrocutaneous fistulas and six (1.9%) demonstrated dehiscence. Overall, 2 patients (2.2%) who underwent surgical repair within the first 6 months of age developed complications compared with 23 patients (10.3%) who underwent initial hypospadias repair when they were older than 6 months of age (P = 0.006). Conclusions: Tubularized incised plate, meatoplasty and glanuloplasty, and glans approximation urethroplasty are all excellent options for the surgical correction of hypospadias in the appropriately selected patient. The results of our study have indicated that complications are minimized when hypospadias repair is performed when the patient is 4 to 6 months of age.

    Original languageEnglish
    Pages (from-to)648-651
    Number of pages4
    JournalUrology
    Volume68
    Issue number3
    DOIs
    StatePublished - Sep 2006

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    Hypospadias
    Age Groups
    Surgical Flaps
    Chi-Square Distribution
    Fistula

    ASJC Scopus subject areas

    • Urology

    Cite this

    Impact of patient age on distal hypospadias repair : A surgical perspective. / Perlmutter, Adam E.; Morabito, Rocco; Tarry, William F.

    In: Urology, Vol. 68, No. 3, 09.2006, p. 648-651.

    Research output: Contribution to journalArticle

    Perlmutter, Adam E. ; Morabito, Rocco ; Tarry, William F. / Impact of patient age on distal hypospadias repair : A surgical perspective. In: Urology. 2006 ; Vol. 68, No. 3. pp. 648-651.
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    abstract = "Objectives: To assess whether the age at which the initial hypospadias repair is performed influences the complication rate of hypospadias repair. Methods: The records of 325 consecutive patients who underwent initial hypospadias repair were reviewed. The patients with glanular and coronal hypospadias underwent repair with either meatoplasty and glanuloplasty or a glans approximation procedure. Patients with subcoronal hypospadias and penile hypospadias underwent repair with tubularized incised plate urethroplasty. The patients were divided into 6-month age groups, and the complication rates were analyzed by age group using the chi-square test. Results: A total of 325 hypospadias repairs were performed from January 1999 to January 2005 by a single surgeon. Of the 325 cases, 194 tubularized incised plate procedures were performed, 69 meatoplasty and glanuloplasty procedures were performed, and 53 glans approximation procedures were performed. Nine tubularized island flap urethroplasties performed for penoscrotal hypospadias were excluded because we did not perform a significant number of proximal urethroplasties. Nineteen patients (6.0{\%}) developed urethrocutaneous fistulas and six (1.9{\%}) demonstrated dehiscence. Overall, 2 patients (2.2{\%}) who underwent surgical repair within the first 6 months of age developed complications compared with 23 patients (10.3{\%}) who underwent initial hypospadias repair when they were older than 6 months of age (P = 0.006). Conclusions: Tubularized incised plate, meatoplasty and glanuloplasty, and glans approximation urethroplasty are all excellent options for the surgical correction of hypospadias in the appropriately selected patient. The results of our study have indicated that complications are minimized when hypospadias repair is performed when the patient is 4 to 6 months of age.",
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    AB - Objectives: To assess whether the age at which the initial hypospadias repair is performed influences the complication rate of hypospadias repair. Methods: The records of 325 consecutive patients who underwent initial hypospadias repair were reviewed. The patients with glanular and coronal hypospadias underwent repair with either meatoplasty and glanuloplasty or a glans approximation procedure. Patients with subcoronal hypospadias and penile hypospadias underwent repair with tubularized incised plate urethroplasty. The patients were divided into 6-month age groups, and the complication rates were analyzed by age group using the chi-square test. Results: A total of 325 hypospadias repairs were performed from January 1999 to January 2005 by a single surgeon. Of the 325 cases, 194 tubularized incised plate procedures were performed, 69 meatoplasty and glanuloplasty procedures were performed, and 53 glans approximation procedures were performed. Nine tubularized island flap urethroplasties performed for penoscrotal hypospadias were excluded because we did not perform a significant number of proximal urethroplasties. Nineteen patients (6.0%) developed urethrocutaneous fistulas and six (1.9%) demonstrated dehiscence. Overall, 2 patients (2.2%) who underwent surgical repair within the first 6 months of age developed complications compared with 23 patients (10.3%) who underwent initial hypospadias repair when they were older than 6 months of age (P = 0.006). Conclusions: Tubularized incised plate, meatoplasty and glanuloplasty, and glans approximation urethroplasty are all excellent options for the surgical correction of hypospadias in the appropriately selected patient. The results of our study have indicated that complications are minimized when hypospadias repair is performed when the patient is 4 to 6 months of age.

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