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Published on: January 7, 2019
Post-pubertal outcomes of hypospadias surgery performed during infancy: High satisfaction with urinary function and
Annaleena Anttila1, Niklas Pakkasjärvi2, Seppo Taskinen2
1Department of Pediatric Surgery, Section of Pediatric Urology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Department of Pediatric Surgery, Tampere University Hospital, Tampere, Finland.
Insights
Long-term lower urinary tract symptoms (LUTS) after hypospadias repair are rare and comparable to controls. Early detection and management of complications like strictures are key for good urinary function outcomes.
Area of Science:
- Pediatric Urology
- Surgical Outcomes
- Lower Urinary Tract Symptoms
Background:
- Hypospadias repair in infancy can have long-term implications.
- Assessing lower urinary tract symptoms (LUTS) post-puberty is crucial for evaluating surgical success.
Purpose of the Study:
- To evaluate long-term LUTS in post-pubertal patients after hypospadias repair.
- To compare LUTS in operated patients with a healthy control group.
- To determine the impact of hypospadias severity and stricture complications on LUTS.
Main Methods:
- Patient-reported LUTS were assessed using the DAN-PSS questionnaire in 176 post-pubertal patients.
- Patients underwent hypospadias repair during infancy (median age 1.4 years).
- Results were compared to a healthy control group, and the influence of hypospadias severity and stricture treatment was analyzed.
Main Results:
- At a median age of 16.3 years, 19% of patients had undergone stricture treatment.
- Frequent or severely disturbing voiding/storage symptoms were rare and comparable to controls (p > 0.05).
- Hypospadias severity and prior stricture treatment did not significantly impact LUTS occurrence.
Conclusions:
- Most patients reported satisfaction with urinary function after urethroplasty.
- Long-term LUTS do not significantly increase after hypospadias repair if complications are managed.
- Structured follow-up is essential for detecting and treating complications to ensure optimal long-term outcomes.
Objectives:
To assess long-term lower urinary tract symptoms (LUTS) in post-pubertal patients operated on for hypospadias during infancy.
Patients And Methods:
We analysed patient-reported LUTS in 176 post-pubertal patients born between 1991 and 2003, who underwent early hypospadias repair at a median age of 1.4 years (IQR 1.1-1.9). At their last follow-up visit, patients returned pre-mailed questionnaires evaluating LUTS before transitioning from the pediatric unit. The results were compared to a healthy control group. We also assessed the impact of hypospadias severity on voiding and storage symptoms.
Results:
At a median age of 16.3 years, 19 % of patients had undergone stricture treatment following hypospadias repair. Frequent (often/always) or severely disturbing (moderate/major) voiding or storage symptoms were rare and comparable to controls according to DAN-PSS questionnaire (p > 0.05 for all comparisons). Most symptoms were mild, and the occurrence of mild symptoms varied between patients and controls. The severity of hypospadias did not affect the occurrence of voiding or storage symptoms. The occurrence of bothersome LUTS was also similar between patients with and without prior stricture treatment (p > 0.5 for all).
Conclusion:
Most patients reported satisfaction with their urinary function after urethroplasty, indicating that long-term LUTS do not significantly increase following hypospadias when complications including strictures are identified and managed. To enable long-term outcomes after childhood hypospadias surgery, structured follow-up is essential to detect and treat such complications.
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