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Hypospadias repair below 12 months associated with more reinterventions: Study
Researchers from a recent study have observed that hypospadias repair below 12 months was associated with more reinterventions, as published in the Journal of Urology.
Hypospadias repair is a procedure carried out to correct a defect in the opening of the penis that is present at birth. The urethra does not end at the tip of the penis. Instead, it ends on the underside of the penis. Literature does not provide ample research in assessing the association between adolescent and young adult urogenital outcome following childhood hypospadias repair.
Therefore, Lloyd J. W. Tack and colleagues from the Department of Internal Medicine and Paediatrics, Division of Paediatric Endocrinology, Ghent University Hospital, Ghent University, Ghent, Belgium conducted the present study to assess the long-term surgical, functional urinary and sexual outcomes of adolescent and young adult men who underwent childhood hypospadias repair.
Men born with nonsyndromic hypospadias and healthy male controls aged 16–21 years old were recruited, and their surgical, urinary, sexual functional and aesthetic outcomes assessed. Good outcome was defined as a patent and orthotopic meatus without fistulas, and straight erections (<30 degree curvature) without erectile or ejaculatory problems.
Statistics included regression analyses, chi-square/Fisher exact tests and Student's t/Mann-Whitney U and Kruskal-Wallis tests.
The following findings were seen-
a. A total of 193 patients and 50 controls participated 16.4 years (range 8.2–21.2) after initial repair.
b. At least 1 reintervention was performed in 39.2%.
c. The highest reintervention rate was found in those younger than 12 months at initial repair, even when excluding proximal hypospadias cases.
d. A disturbed urinary and/or suboptimal sexual functional outcome was seen in 52.9% of cases. e. Suboptimal voiding was found in 22.1%, although few had relevant residual urine.
f. More reinterventions and proximal hypospadias cases were associated with suboptimal urinary outcome, and the latter also with impaired sexual function.
g. Poor inter-observer agreements were found between physician and patient genital appraisal.
Hence, the authors concluded that "in 52.9% of cases, at least 1 concern was identified that required long-term followup. Hypospadias repair below 12 months was associated with more reinterventions. Adopting a restrictive attitude toward aesthetic refinement, unless on the patient's own request, could improve urinary outcomes."
BDS, MDS( Pedodontics and Preventive Dentistry)
Dr. Nandita Mohan is a practicing pediatric dentist with more than 5 years of clinical work experience. Along with this, she is equally interested in keeping herself up to date about the latest developments in the field of medicine and dentistry which is the driving force for her to be in association with Medical Dialogues. She also has her name attached with many publications; both national and international. She has pursued her BDS from Rajiv Gandhi University of Health Sciences, Bangalore and later went to enter her dream specialty (MDS) in the Department of Pedodontics and Preventive Dentistry from Pt. B.D. Sharma University of Health Sciences. Through all the years of experience, her core interest in learning something new has never stopped. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751