Prevalence, assessment and surgical correction of penile curvature in hypospadias patients treated at one European Referral Center: description of the technique and surgical outcomes
Penile curvature (PC) is a common component of hypospadias, but its presence is inconstantly assessed. We aim to report prevalence of PC in hypospadias patients, as well as to report our method to assess and correct PC, with the associated postoperative outcomes.
We scrutinized 303 pediatric hypospadias patients operated (2013–2018) at our referral center. PC was routinely assessed and eventually corrected with dorsal plications (DP) as one-stage procedure, or ventral tunica attenuations ± DP as two-stage repair. PC severity and surgical treatment of PC were compared between primary and failed hypospadias. Finally, PC severity, failed repair and PC treatment were tested as predictors of perioperative complications.
PC (> 10°) was identified in 274/303 (90.4%) patients, 86.1% with distal, 91.8% with midshaft, and 100% with proximal hypospadias, respectively. PC was found in 51/64 (79.7%) of failed hypospadias. One-stage and two-stage procedures were adopted in 211/274 (77%) and 63/274 (23%) children, respectively. PC severity (p = 0.1) and PC treatment (p = 0.4) did not differ between primary and failed hypospadias. PC severity (all p > 0.2), failed repair (p = 0.8), and PC treatment (all p > 0.09) were not predictors of perioperative complications. 95.6% of patients achieved a straight penis.
Less than 1/10 patients did not require PC correction. High rate of residual PC in failed hypospadias and similar severity between failed and primary suggest that PC was usually under-corrected. It is possible to correct PC completely and the resulting complication would not be associated with PC severity, failed repair or treatment adopted.
KeywordsHypospadias Penile curvature Pediatric urology Chordee Referral Center
Buccal mucosa graft
Univariable logistic regression
Multivariable logistic regression
Disorders of sex development
We thank all the employees of the BelMedicGeneral Hospital for their support. I also personally thank Dr. Mosca Beatrice for her help drawing the steps of dorsal plications that are visible on Supplementary Fig. 4.
MB protocol/project development, data collection or management, data analysis, manuscript writing/editing. SS data collection or management, manuscript writing/editing. RD manuscript writing/editing, protocol/project development. BS manuscript writing/editing. PK manuscript writing/editing. VP data collection or management. FM protocol/project development. ADD manuscript writing/editing. MS data collection or management. AB protocol/project development. AS protocol/project development.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. During my stay at the Sava Perovic Foundation I was granted by the European Urological Scholarship Programme (EUSP).
Compliance with ethical standards
Conflict of interest
The authors have stated that they have no conflict of interest.
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