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Published on: January 7, 2019
Predictors of surgical complications in boys with hypospadias: data from an internationa registry
Kathryn Scougall1, Jillian Bryce1, Federico Baronio2
1University of Glasgow, Glasgow, UK.
Insights
Boys undergoing hypospadias repair often experience complications. This study found high complication rates in proximal hypospadias cases, but no specific clinical factors were linked to these outcomes.
Area of Science:
- Pediatric Surgery
- Urology
- Genetics
Background:
- Hypospadias repair is associated with frequent complications.
- Understanding factors influencing complication rates is crucial for improving surgical outcomes.
Purpose of the Study:
- To investigate clinical factors associated with postsurgical complications in boys with hypospadias.
- To analyze data from the International Disorders of Sex Development (I-DSD) Registry.
Main Methods:
- Retrospective analysis of data from boys with hypospadias (2000-2020).
- Utilized logistic regressions, Fisher's exact tests, and Spearman's correlation.
- Assessed associations between clinical factors and complication rates.
Main Results:
- 160 boys with hypospadias were analyzed; 64% experienced postsurgical complications.
- All patients had genital malformations; 38% had extragenital malformations.
- No significant associations were found between clinical factors and complication rates.
Conclusions:
- Boys with proximal hypospadias have high comorbidity and complication rates.
- The high incidence of complications suggests unknown contributing factors requiring further research.
- Current clinical factors do not predict postsurgical complications in this cohort.
Background:
Complications are frequently reported after hypospadias repair and there is a need to understand the factors that influence their occurrence.
Methods:
Data from boys with hypospadias born between 2000 and 2020 were obtained from the International Disorders of Sex Development (I-DSD) Registry. Logistic regressions, fisher's exact tests and spearman's correlation tests were performed on the data to assess associations between clinical factors and complication rates.
Results:
Of the 551 eligible boys, data were available on 160 (29%). Within the cohort, the median (range) External Masculinization Score (EMS) was 6 (2, 9). All presented with one or more additional genital malformation and 61 (38%) presented with additional extragenital malformations. Disorders of androgen action, androgen synthesis and gonadal development were diagnosed in 28 (18%), 22 (14%) and 9 (6%) boys, respectively. The remaining 101 (62%) patients were diagnosed as having non-specific 46,XY Disorders of Sex Development. Eighty (50%) boys had evidence of abnormal biochemistry, and gene variants were identified in 42 (26%). Median age at first hypospadias surgery was 2 years (0, 9), and median length of follow-up was 5 years (0, 17). Postsurgical complications were noted in 102 (64%) boys. There were no significant associations with postsurgical complications.
Conclusions:
Boys with proximal hypospadias in the I-DSD Registry have high rates of additional comorbidities and a high risk of postoperative complications. No clinical factors were significantly associated with complication rates. High complication rates with no observable cause suggest the involvement of other factors which need investigation.
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