MP47-14 TIME TO EVENT ANALYSIS FOR COMPLICATION SPECIFIC OCCURRENCE IN POST-HYPOSPADIAS REPAIR: A SINGLE SURGEON EXPERIENCE

Abstract

You have accessJournal of UrologyPediatric Urology III (MP47)1 Sep 2021MP47-14 TIME TO EVENT ANALYSIS FOR COMPLICATION SPECIFIC OCCURRENCE IN POST-HYPOSPADIAS REPAIR: A SINGLE SURGEON EXPERIENCE Jin Kyu (Justin) Kim, Mitchell Shiff, Michael Chua, Fadi Zu'bi, Jessica Ming, Martha Pokarowski, and Walid Farhat Jin Kyu (Justin) KimJin Kyu (Justin) Kim More articles by this author , Mitchell ShiffMitchell Shiff More articles by this author , Michael ChuaMichael Chua More articles by this author , Fadi Zu'biFadi Zu'bi More articles by this author , Jessica MingJessica Ming More articles by this author , Martha PokarowskiMartha Pokarowski More articles by this author , and Walid FarhatWalid Farhat More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002068.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The optimal follow up duration and frequency following hypospadias repair is unclear within the pediatric urology community. This investigation aims to delineate the time to various complications following primary hypospadias repairs. METHODS: A retrospective review of a single surgeon hypospadias database over 2001-2017 was performed. The primary outcome of the study was determining the significant factors leading to complications over time. As a secondary outcome, subgroup analysis was performed to determine whether there was a significant difference in time to detecting urine-related complications (fistula, stricture/stenosis, diverticulum) based on age. RESULTS: 832 patients were identified. The complication rates for distal, midshaft, and proximal hypospadias were 17.9% (112/625), 36.7% (40/109), and 55.1% (49/89), respectively (p<0.0001). Survival analysis using Kaplan-Meier Curves showed significance in three variables for time to complication: hypospadias severity (p<0.0001), technique (p<0.0001), and penile curvature >30° (p<0.0001; Figure 1). Cox-regression analysis showed that hypospadias severity and penile curvature were significantly contributing to the model (p<0.0001, p=0.044). Patients with proximal hypospadias and penile curvature developed complications earlier than other patients, with approximately 95% of complications occurring within 2 years (Table 1). A subgroup analysis of complications based on age and urine-related complications showed that patients <18 months of age were likely to have their urine-related complications detected earlier (8.8 months [IQR 4.4-25.5] vs. 16.5 months [IQR 6.4-44.6], p=0.030). CONCLUSIONS: Complications from repair of proximal hypospadias with curvature >30° are likely to occur within 2 years of surgery. Patients younger than toilet-training age may have earlier detection of complications such as fistulas and meatal stenosis, prompting further evaluation of the role of toilet training in detection of complications. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e828-e829 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jin Kyu (Justin) Kim More articles by this author Mitchell Shiff More articles by this author Michael Chua More articles by this author Fadi Zu'bi More articles by this author Jessica Ming More articles by this author Martha Pokarowski More articles by this author Walid Farhat More articles by this author Expand All Advertisement Loading ...