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- Title
Foreskin reconstruction vs circumcision in distal hypospadias.
- Authors
Rampersad, Rajay; Nyo, Yoke; Hutson, John; O'Brien, Mike; Heloury, Yves; Nyo, Yoke Lin
- Abstract
<bold>Purpose: </bold>The purpose of the study was to determine if there were differences in the complication rates between foreskin reconstruction (FR) and circumcision (CIRC) in distal hypospadias repairs. The primary outcomes were urethrocutaneous fistula (UF) and dehiscence.<bold>Methods: </bold>The data of distal hypospadias operated between 2005 and 2013 were retrospectively reviewed. The inclusion criteria were any distal hypospadias repair that required an urethroplasty. The exclusion criteria were follow-up <1 year, redo procedures, chordee greater than 20°, and incomplete data. Univariate and multivariate analysis was performed on the results.<bold>Results: </bold>213 patients were included (95 FR and 118 CIRC). The 2 groups were comparable for age at surgery 19.32 months in FR and 14.25 months in CIRC. Mathieu repair was more common in FR (47/95-49.47%) than in CIRC (45/118-38.14%). The total subsequent procedures required were 23 in FR and 57 in CIRC. The incidence of UF was 6.3% (6/95) in FR and 27.1% (32/118) in CIRC (p < 0.001, OR 5.52, 95% CI 2.2-13.9). Complete dehiscence rates were 3.16% (3/95) FR vs 11.02% (13/118) for CIRC (p = 0.037, OR 3.8, 95% CI 1.05-13.74). The incidence of patients requiring reoperation was 18.9% (18/95) in FR versus 45.8% (54/118) in CIRC (p < 0.001, OR 3.61, 95% CI 1.93-6.76).<bold>Conclusions: </bold>Foreskin Reconstruction conferred a significantly lower rate of complications, particularly the UF rate, dehiscence rate, and number of patients that required reoperation. Our rate of complications in the CIRC group is much higher than other published data.
- Subjects
HYPOSPADIAS; FORESKIN surgery; SURGICAL complications; HEALTH outcome assessment; MULTIVARIATE analysis; PENIS surgery; URETHRA surgery; CIRCUMCISION; COMPARATIVE studies; UROLOGICAL surgery; RESEARCH methodology; MEDICAL cooperation; MEN; RESEARCH; PLASTIC surgery; EVALUATION research; TREATMENT effectiveness; RETROSPECTIVE studies
- Publication
Pediatric Surgery International, 2017, Vol 33, Issue 10, p1131
- ISSN
0179-0358
- Publication type
journal article
- DOI
10.1007/s00383-017-4151-y