Trends in Hypospadias Surgery: Results of a Worldwide Survey

被引:149
作者
Springer, Alexander [1 ]
Krois, Wilfried [1 ]
Horcher, Ernst [1 ]
机构
[1] Med Univ Vienna, Dept Paediat Surg, Vienna, Austria
关键词
Chordee; Hypospadias; Questionnaire; Survey; TIP; Two stage repair; REPAIR; OUTCOMES; CHORDEE;
D O I
10.1016/j.eururo.2011.08.031
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
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 308; 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 distalhypospadias, 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. (C) 2011 European Association of Urology. Published by Elsevier B. V. All rights reserved.
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收藏
页码:1184 / 1189
页数:6
相关论文
共 29 条
[1]  
Akbiyik F, 2009, UROLOGY, V73, P1255, DOI 10.1016/j.urology.2008.06.075
[2]   Retrospective Descriptive Analysis of 1,176 Patients With Failed Hypospadias Repair [J].
Barbagli, Guido ;
Perovic, Sava ;
Djinovic, Rados ;
Sansalone, Salvatore ;
Lazzeri, Massimo .
JOURNAL OF UROLOGY, 2010, 183 (01) :207-211
[3]   Surgical Management of Primary Severe Hypospadias in Children: Systematic 20-Year Review EDITORIAL COMMENT [J].
Baskin, Laurence .
JOURNAL OF UROLOGY, 2010, 184 (04) :1474-1475
[4]   Chordee: Varied opinions and treatments as documented in a survey of the American Academy of Pediatrics, Section of Urology [J].
Bologna, RA ;
Noah, TA ;
Nasrallah, PF ;
McMahon, DR .
UROLOGY, 1999, 53 (03) :608-612
[5]   The role of two-stage repair in modern hypospadiology [J].
Bracka, Aivar .
INDIAN JOURNAL OF UROLOGY, 2008, 24 (02) :210-218
[6]   Comparative analysis of tubularized incised plate versus Onlay island flap urethroplasty for penoscrotal hypospadias [J].
Braga, Luis H. P. ;
Salle, Joao L. Pippi ;
Lorenzo, Armando J. ;
Skeldon, Sean ;
Dave, Sumit ;
Farhat, Walid A. ;
Khoury, Antoine E. ;
Bagli, Darius J. .
JOURNAL OF UROLOGY, 2007, 178 (04) :1451-1456
[7]  
Büyükünal C, 2003, HYPOSPADIAS SURGERY: AN ILLUSTRATED GUIDE, P3
[8]   Surgical Management of Primary Severe Hypospadias in Children: Systematic 20-Year Review [J].
Castagnetti, Marco ;
El-Ghoneimi, Alaa .
JOURNAL OF UROLOGY, 2010, 184 (04) :1469-1474
[9]   A multicenter evaluation of technical preferences for primary hypospadias repair [J].
Cook, A ;
Khoury, AE ;
Neville, C ;
Bagli, DJ ;
Farhat, WA ;
Salle, JLP .
JOURNAL OF UROLOGY, 2005, 174 (06) :2354-2357
[10]  
DUCKETT JW, 1981, UROL CLIN N AM, V8, P513