Trends in hypospadias surgery: results of a worldwide survey.

Abstract

BACKGROUND:

Hypospadias is a challenging field of urogenital reconstructive surgery, with different techniques currently being used.

OBJECTIVE:

Evaluate international trends in hypospadias surgery.

DESIGN, SETTING, AND PARTICIPANTS:

Paediatric urologists, paediatric surgeons, urologists, and plastic surgeons worldwide were invited to participate an anonymous online questionnaire (http://www.hypospadias-center.info).

MEASUREMENTS:

General epidemiologic data, preferred technique in the correction of hypospadias, and preferred technique in the correction of penile curvature were gathered.

RESULTS AND LIMITATIONS:

Three hundred seventy-seven participants from 68 countries returned completed questionnaires. In distal hypospadias (subcoronal to midshaft), the tubularised incised plate (TIP) repair is preferred by 52.9-71.0% of the participants. Meatal advancement and glanuloplasty (MAGPI) is still a preferred method in glandular hypospadias. In the repair of proximal hypospadias, the two-stage repair is preferred by 43.3-76.6%. TIP repair in proximal hypospadias is used by 0.9-16.7%. Onlay flaps and tubes are used by 11.3-29.5% of the study group. Simple plication and Nesbit's procedure are the techniques of choice in curvature up to 30°; urethral division and ventral incision of the tunica albuginea with grafting is performed by about 20% of the participants in severe chordee. The frequency of hypospadias repairs does not influence the choice of technique.

CONCLUSIONS:

In this study, we identified current international trends in the management of hypospadias. In distal hypospadias, the TIP repair is the preferred technique. In proximal hypospadias, the two-stage repair is most commonly used. A variety of techniques are used for chordee correction. This study contains data on the basis of personal experience. However, future research must focus on prospective controlled trials.

• Authors: Alexander Springer, Wilfried Krois, Ernst Horcher
• Journal: European urology (Eur Urol) Vol. 60 Issue 6 Pg. 1184-9 (Dec 2011) ISSN: 1873-7560 [Electronic] Switzerland
• PMID: 21871708 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Topics

• Adult
• Africa (epidemiology)
• Asia (epidemiology)
• Australia (epidemiology)
• Chi-Square Distribution
• Europe (epidemiology)
• Female
• Health Care Surveys
• Humans
• Hypospadias (epidemiology, surgery)
• Internet
• Male
• Middle Aged
• North America (epidemiology)
• Penis (abnormalities, surgery)
• Plastic Surgery Procedures (trends)
• South America (epidemiology)
• Surveys and Questionnaires
• Urologic Surgical Procedures, Male (trends)
• Young Adult