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

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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.

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References

  1. Long CJ, Canning DA (2016) Hypospadias: are we as good as we think when we correct proximal hypospadias? J Pediatr Urol 12(4):196.e1–196.e5

    Article  CAS  Google Scholar 

  2. Stanasel I et al (2015) Complications following staged hypospadias repair using transposed preputial skin flaps. J Urol 194(2):512–516

    Article  PubMed  PubMed Central  Google Scholar 

  3. Salle JLP et al (2016) Proximal hypospadias: a persistent challenge. Single institution outcome analysis of three surgical techniques over a 10-year period. J. Pediatr. Urol. 12(1):28.e1–28.e7

    Article  Google Scholar 

  4. Long CJ et al (2017) Intermediate-term followup of proximal hypospadias repair reveals high complication rate. J Urol 197(3):852–858

    Article  PubMed  Google Scholar 

  5. McNamara ER et al (2015) Management of proximal hypospadias with 2-stage repair: 20-year experience. J Urol 194(4):1080–1085

    Article  PubMed  PubMed Central  Google Scholar 

  6. Palmer BW, Reiner W, Kropp BP (2012) Proximal Hypospadias repair outcomes in patients with a specific disorder of sexual development diagnosis. Adv Urol 2012:1–4

    Article  Google Scholar 

  7. Spinoit A-F, Poelaert F, Groen L-A, Van Laecke E, Hoebeke P (2013) Hypospadias repair at a tertiary care center: long-term followup is mandatory to determine the real complication rate. J Urol 189:2276e81

    Article  Google Scholar 

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Acknowledgements

Carter Sevick, MS for statistical support.

Funding

None.

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Authors and Affiliations

  1. Division of Urology, Department of Surgery, University of Colorado and Children’s Hospital Colorado, 13123 E 16th Ave., Box 463, Aurora, CO, 80045, USA

    Amanda F. Saltzman, Alonso Carrasco Jr., Alexandra Colvin, Jeffrey B. Campbell, Vijaya M. Vemulakonda & Duncan Wilcox

Authors
  1. Amanda F. Saltzman
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  2. Alonso Carrasco Jr.
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  3. Alexandra Colvin
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  4. Jeffrey B. Campbell
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  5. Vijaya M. Vemulakonda
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  6. Duncan Wilcox
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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.

Corresponding author

Correspondence to Amanda F. Saltzman.

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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.

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Saltzman, A.F., Carrasco, A., Colvin, A. et al. Patients with disorders of sex development and proximal hypospadias are at high risk for reoperation. World J Urol 36, 2051–2058 (2018). https://doi.org/10.1007/s00345-018-2350-3

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  • DOI: https://doi.org/10.1007/s00345-018-2350-3

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