MP65-20 THE HYPOSPADIAS COMPLICATION RATE IN CHILDREN WITH SEVERE EXTRA-GENITAL ANOMALIES: ARE WE STAGING FOR A REASON?

Abstract

You have accessJournal of UrologyPediatrics: Hypospadias and Penile Surgery (MP65)1 Apr 2020MP65-20 THE HYPOSPADIAS COMPLICATION RATE IN CHILDREN WITH SEVERE EXTRA-GENITAL ANOMALIES: ARE WE STAGING FOR A REASON? Sarah Holzman*, Carol Davis-Dao, Zayn Suhale, Amanda Macaraeg, Joshua Chamberlin, Kai-wen Chuang, Heidi Stephany, Elias Wehbi, and Antoine Khoury Sarah Holzman*Sarah Holzman* More articles by this author , Carol Davis-DaoCarol Davis-Dao More articles by this author , Zayn SuhaleZayn Suhale More articles by this author , Amanda MacaraegAmanda Macaraeg More articles by this author , Joshua ChamberlinJoshua Chamberlin More articles by this author , Kai-wen ChuangKai-wen Chuang More articles by this author , Heidi StephanyHeidi Stephany More articles by this author , Elias WehbiElias Wehbi More articles by this author , and Antoine KhouryAntoine Khoury More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000940.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients with hypospadias may have extra-genital anomalies. The effect of these anomalies on surgical planning and complication rates are not well defined. We sought to review our experience with hypospadias and identify if patients with extra-genital anomalies had higher complication rates. METHODS: We reviewed a prospectively-managed hypospadias database for patients who underwent hypospadias repair at our institution from 2008-2019. We identified patients with complex genetic syndromes or severe neurologic, cardiac or gastrointestinal anomalies. Patients with prior hypospadias repair performed outside our institution were excluded. We evaluated hypospadias severity, type of repair and complications. Complications were stratified by severity ranging from simple complications to severe. Primary outcome was complication rate. Analyses were conducted using Chi-square and logistic regression. RESULTS: Our database included 733 patients including 26 patients with severe anomalies. Meatal location was recorded as distal, mid-shaft and proximal in 13, 6 and 11 patients with severe anomalies, respectively. Twelve children had severe cardiac anomalies including tetralogy of Fallot, transposition of the great arteries, atrial and ventral septal defects. Three children had VATER, 5 children had neurologic syndromes and 6 had chromosomal anomalies. Complication rate amongst children with extra-genital anomalies was 19% (5/26) compared to 15% (105/707) in children without anomalies but this was not significant (p=0.54). There was no difference in severe complications between the two groups. The rate of planned staged procedures was higher in children with extra-genital anomalies with 23% (6/26) staged procedures compared to 6% in children without these anomalies (39/666, p=0.0005). In regression analysis, staged procedures remained significant when adjusting for hypospadias location (OR= 3.5, 95% CI: 1.1-12, p=0.04). We did not find an association between severe extra-genital anomalies and complication rate adjusting for single or staged procedure and hypospadias location (OR= 0.88, 95% CI: 0.29-2.6, p=0.81). CONCLUSIONS: Children with severe extra-genital anomalies had a higher staged repair rate compared to their peers; however, their complication rate did not differ. Staged repair may have a protective effect against complications as these children are thought to have impaired wound healing. Given the rare nature of hypospadias with severe anomalies, further study is required to verify these findings. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e981-e981 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sarah Holzman* More articles by this author Carol Davis-Dao More articles by this author Zayn Suhale More articles by this author Amanda Macaraeg More articles by this author Joshua Chamberlin More articles by this author Kai-wen Chuang More articles by this author Heidi Stephany More articles by this author Elias Wehbi More articles by this author Antoine Khoury More articles by this author Expand All Advertisement PDF downloadLoading ...