Age does not impact risk for urethroplasty complications after tubularized incised plate repair of hypospadias in prepubertal boys

Abstract

ObjectivePatients often present before or after the recommended age of 6–18 months for hypospadias repair. Reports indicate complications may increase when repair is delayed past 6–12 months of age. We questioned if age was an independent risk for urethroplasty complications (UC). MethodsA prospectively maintained database of consecutive patients undergoing tubularized incised plate (TIP) repair was queried for age at surgery, primary or reoperative TIP, meatal location, glansplasty suture, and learning curve. The presence of UC (fistula, dehiscence, stricture, meatal stenosis) was analyzed with logistic regression. ResultsTIP repairs were performed for 669 consecutive prepubertal patients aged 3–144 months (mean 17.1, SD 22.5). Original meatal location was distal in 540 (80.7%), midshaft in 50 (7.5%), and proximal in 79 (11.8%). Reoperative TIP occurred in 73 (10.9%). UC occurred in 77 (11.5%). Reoperative TIP (OR 3.07, 95% CI 1.54–6.13) and meatal location (OR 1.79, 95% CI 1.34–2.40) were the only independent risk factors for UC. Neither younger nor older age increased risk for UC. ConclusionsOur data from consecutive TIP repairs in prepubertal children indicate age at surgery does not increase odds of UC. Surgery can be performed any time after 3 months (in full-term, healthy boys) without raising the rate of UC.