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World Journal of Urology

, Volume 36, Issue 12, pp 2051–2058 | Cite as

Patients with disorders of sex development and proximal hypospadias are at high risk for reoperation

  • Amanda F. Saltzman
  • Alonso CarrascoJr.
  • Alexandra Colvin
  • Jeffrey B. Campbell
  • Vijaya M. Vemulakonda
  • Duncan Wilcox
Original Article
  • 86 Downloads

Abstract

Purpose

Surgical repair for proximal hypospadias has been associated with long-term success rates of 32–68%. In a prior study, outcomes for proximal hypospadias in patients with a diagnosis of disorders of sex development (DSD) were no different than those of patients without DSD. The objective of our study is to report our experience with proximal hypospadias repair in patients with and without DSD.

Methods

We retrospectively reviewed patients who underwent repair of proximal hypospadias between 2005 and 2016. Data collected included patient and disease characteristics, operative details, complications, and follow-up. The primary outcome was unplanned reoperation.

Results

Sixty seven patients were identified; 30 (44.8%) with DSD and 37 (55.2%) without DSD. Median follow-up was 28.3 months (IQR 18.9–45.7). 41 patients (61.2%) underwent at least one unplanned reoperation, median time to unplanned reoperation 10.3 months. More patients with DSD needed an unplanned reoperation (80 vs. 45.9%, p = 0.024). During the first 12 months after initial repair, there was no difference in unplanned reoperation rates (40 vs. 32.4%, p = 0.611), but there was a difference in the first 24 months post-operatively (76.7 vs. 43.2%, p = 0.007). On multivariate logistic regression, older age at initial repair (OR 1.144) and two stage repair (OR 7.644) were positively associated with unplanned reoperation in the first 2 years after repair.

Conclusions

Proximal hypospadias repair is associated with an overall 61.2% reoperation rate regardless of associated DSD diagnosis. Patients with DSD are more likely to undergo an unplanned reoperation in the first 2 years after repair.

Keywords

Proximal hypospadias Disorder of sex development Complications 

Notes

Acknowledgements

Carter Sevick, MS for statistical support.

Author contributions

AFS protocol/project development, data collection/management, data analysis, manuscript writing/editing; ACJr. protocol/project development, data collection/management, data analysis, manuscript writing/editing; AC protocol/project development, data collection/management, data analysis, manuscript writing/editing; JBC protocol/project development, manuscript editing; VMV protocol/project development, manuscript editing; DW protocol/project development, data collection/management, data analysis, manuscript writing/editing.

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

IRB exemption was obtained for this study, thus formal consent was not required or obtained.

References

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Amanda F. Saltzman
    • 1
  • Alonso CarrascoJr.
    • 1
  • Alexandra Colvin
    • 1
  • Jeffrey B. Campbell
    • 1
  • Vijaya M. Vemulakonda
    • 1
  • Duncan Wilcox
    • 1
  1. 1.Division of Urology, Department of SurgeryUniversity of Colorado and Children’s Hospital ColoradoAuroraUSA

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