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Prevalence, repairs and complications of hypospadias: an Australian population-based study
Francisco Javier Schneuer1, Andrew J A Holland2, Gavin Pereira3
1Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, The University of Sydney, St. Leonards, New South Wales, Australia.
Insights
Hypospadias affects 1 in 285 Australian boys, with 60% needing surgery. One in eight experienced complications, with many occurring over a year post-repair, indicating a need for extended clinical review.
Area of Science:
- Pediatric Urology
- Congenital Abnormalities
- Public Health Surveillance
Background:
- Hypospadias is a common congenital penile anomaly.
- Understanding its prevalence and outcomes is crucial for patient care.
Purpose of the Study:
- To determine the prevalence and trends of hypospadias in New South Wales, Australia.
- To analyze surgical repair rates and post-operative complication frequencies.
- To identify risk factors associated with reoperation and complications.
Main Methods:
- Retrospective analysis of birth and hospital data for live-born infants in New South Wales (2001-2010).
- Evaluation of hypospadias prevalence, surgical procedures, admissions, and complications.
- Multivariate logistic regression used to assess risk factors for reoperation and complications.
Main Results:
- 3186 cases of hypospadias identified; overall prevalence 35.1 per 10,000 live births, constant over the study period.
- 61% of affected boys (1945) underwent surgical repair, with 1718 primary repairs.
- Overall complication rate was 13%, higher (33%) for proximal hypospadias. Over 50% of complications occurred more than one year post-repair.
Conclusions:
- Hypospadias affects approximately 1 in 285 infants, with 60% requiring surgical intervention.
- A significant proportion (1 in 8) experience post-surgical complications, often delayed.
- Extended clinical follow-up beyond one year is recommended due to the frequency of late complications.
Objective:
To investigate hypospadias' prevalence and trends, rate of surgical repairs and post-repair complications in an Australian population.
Methods:
Hypospadias cases were identified from all live-born infants in New South Wales, Australia, during the period 2001-2010, using routinely collected birth and hospital data. Prevalence, trends, surgical procedures or repairs, hospital admissions and complications following surgery were evaluated. Risk factors for reoperation and complications were assessed using multivariate logistic regression.
Results:
There were 3186 boys with hypospadias in 2001-2010. Overall prevalence was 35.1 per 10,000 live births and remained constant during the study period. Proportions of anterior, middle, proximal and unspecified hypospadias were 41.3%, 26.2%, 5.8% and 26.6%, respectively. Surgical procedures were performed in 1945 boys (61%), with 1718 primary repairs. The overall post-surgery complication rate involving fistulas or strictures was 13%, but higher (33%) for proximal cases. Complications occurred after 1 year post-repair in 52.3% of cases and up to 5 years. Boys with proximal or middle hypospadias were at increased risk of reoperation or complications, but age at primary repair did not affect the outcome.
Conclusion:
One in 285 infants were affected with hypospadias, 60% required surgical repair or correction and one in eight experienced complications. The frequency of late complications would suggest that clinical review should be maintained for >1 year post-repair.
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