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Modified Pediatric Penile Perception Scale to Evaluate Cosmetic Outcome in Children With Hypospadias Repair

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Abstract

Objectives

To compare the interpretation for cosmesis post-hypospadias repair by child, parents and surgeons using modified Pediatric Penile Perception Scale (PPPS).

Methods

This cross-sectional study involving 50 children (aged 2 to 17 years) with hypospadias was conducted at the pediatric surgery department of our public sector tertiary care hospital. Subjects were assessed 6 months after completion of all stages of hypospadias repair. Cosmetic assessment was done using modified PPPS. We clubbed together the variables ‘meatus’ and ‘glans’ as MG (meatus-glans) complex due to their extreme proximity (embedding), while cosmesis of phallus was considered independently. The modified PPPS scoring parameters included phallus, MG complex, shaft skin, and general appearance. Independent assessment by surgeon, patients and parents was compared, and analyzed using SAS 9.2 statistical software. Cosmetic results of single vs staged repair, and different repair types was compared.

Results

Assessment using modified PPPS showed that MG complex cosmesis and skin scarring were the most heeded parameters by all three categories of observers. PPPS by surgeons remained least affected by phallic cosmesis and that of the patient by the overall phallic appearance. Tubularized incised plate urethroplasty (TIPU) scored better on cosmesis.

Conclusion

Phallic cosmesis should be considered an independent variable for assessing cosmetic outcome of hypospadias, apart from MG cosmesis.

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Funding

Funding: None

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Authors and Affiliations

  1. Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, 110 002, India

    Simmi K. Ratan

  2. Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalya, New Delhi, India

    Parveen Kumar

  3. Department of Pediatric Surgery, Vardhman Mahavir Medical College, New Delhi, India

    Jugal Kishore

  4. Department of Pediatric Surgery, Ganga Ram Hospital, New Delhi, India

    Satish Kumar Aggarwal

Authors
  1. Simmi K. Ratan
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  2. Parveen Kumar
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  3. Jugal Kishore
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  4. Satish Kumar Aggarwal
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Contributions

Contributors: SKR, PK, JK, SKA: concepts, design, definition of intellectual content, literature search, clinical studies, data acquisition, data analysis, manuscript preparation, manuscript editing, manuscript review; SKR: guarantor of the study. All authors approved the final version of manuscript, and are accountable for all aspects related to the study.

Corresponding author

Correspondence to Simmi K. Ratan.

Ethics declarations

Ethics clearance: IEC, Maulana Azad Medical College; dated Nov, 2014. (No number allotted).

Competing interests: None stated.

Additional information

Note: Additional material related to this study is available with the online version at https://www.indianpediatrics.net

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Ratan, S.K., Kumar, P., Kishore, J. et al. Modified Pediatric Penile Perception Scale to Evaluate Cosmetic Outcome in Children With Hypospadias Repair. Indian Pediatr 60, 655–658 (2023). https://doi.org/10.1007/s13312-023-2966-2

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  • DOI: https://doi.org/10.1007/s13312-023-2966-2

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