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Adolescent and young adult urogenital outcome following childhood hypospadias repair : perfection revisited

(2021) JOURNAL OF UROLOGY. 206(3). p.734-743
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Abstract
Purpose: We assessed the long-term surgical, functional urinary and sexual outcomes of adolescent and young adult men who underwent childhood hypospadias repair. Materials and Methods: Men born with nonsyndromic hypospadias and healthy male controls aged 16-21 years old were recruited, and their surgical, urinary, sexual functional and aesthetic outcomes assessed. Good outcome was defined as a patent and orthotopic meatus without fistulas, and straight erections (<30 degree curvature) without erectile or ejaculatory problems. Statistics included regression analyses, chi-square/Fisher exact tests and Student's t/Mann-Whitney U and Kruskal-Wallis tests. Results: A total of 193 patients and 50 controls participated 16.4 years (range 8.2-21.2) after initial repair. At least 1 reintervention was performed in 39.2%. The highest reintervention rate was found in those younger than 12 months at initial repair, even when excluding proximal hypospadias cases. A disturbed urinary and/or suboptimal sexual functional outcome was seen in 52.9% of cases. Suboptimal voiding was found in 22.1%, although few had relevant residual urine. More reinterventions and proximal hypospadias cases were associated with suboptimal urinary outcome, and the latter also with impaired sexual function. Poor inter-observer agreements were found between physician and patient genital appraisal. Conclusions: In 52.9% of cases, at least 1 concern was identified that required long-term followup. Hypospadias repair below 12 months was associated with more reinterventions. Adopting a restrictive attitude toward aesthetic refinement, unless on the patient's own request, could improve urinary outcomes.
Keywords
Urology, hypospadias, treatment outcome, urologic surgical procedures, male, COMPLICATIONS, RISK

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MLA
Tack, Lloyd, et al. “Adolescent and Young Adult Urogenital Outcome Following Childhood Hypospadias Repair : Perfection Revisited.” JOURNAL OF UROLOGY, vol. 206, no. 3, 2021, pp. 734–43, doi:10.1097/ju.0000000000001869.
APA
Tack, L., Springer, A., Riedl, S., Tonnhofer, U., Hiess, M., Weninger, J., … Spinoit, A.-F. (2021). Adolescent and young adult urogenital outcome following childhood hypospadias repair : perfection revisited. JOURNAL OF UROLOGY, 206(3), 734–743. https://doi.org/10.1097/ju.0000000000001869
Chicago author-date
Tack, Lloyd, Alexander Springer, Stefan Riedl, Ursula Tonnhofer, Manuela Hiess, Julia Weninger, Ahmed Mahmoud, et al. 2021. “Adolescent and Young Adult Urogenital Outcome Following Childhood Hypospadias Repair : Perfection Revisited.” JOURNAL OF UROLOGY 206 (3): 734–43. https://doi.org/10.1097/ju.0000000000001869.
Chicago author-date (all authors)
Tack, Lloyd, Alexander Springer, Stefan Riedl, Ursula Tonnhofer, Manuela Hiess, Julia Weninger, Ahmed Mahmoud, Erik Van Laecke, Piet Hoebeke, Martine Cools, and Anne-Françoise Spinoit. 2021. “Adolescent and Young Adult Urogenital Outcome Following Childhood Hypospadias Repair : Perfection Revisited.” JOURNAL OF UROLOGY 206 (3): 734–743. doi:10.1097/ju.0000000000001869.
Vancouver
1.
Tack L, Springer A, Riedl S, Tonnhofer U, Hiess M, Weninger J, et al. Adolescent and young adult urogenital outcome following childhood hypospadias repair : perfection revisited. JOURNAL OF UROLOGY. 2021;206(3):734–43.
IEEE
[1]
L. Tack et al., “Adolescent and young adult urogenital outcome following childhood hypospadias repair : perfection revisited,” JOURNAL OF UROLOGY, vol. 206, no. 3, pp. 734–743, 2021.
@article{8717403,
  abstract     = {{Purpose: We assessed the long-term surgical, functional urinary and sexual outcomes of adolescent and young adult men who underwent childhood hypospadias repair. 

Materials and Methods: Men born with nonsyndromic hypospadias and healthy male controls aged 16-21 years old were recruited, and their surgical, urinary, sexual functional and aesthetic outcomes assessed. Good outcome was defined as a patent and orthotopic meatus without fistulas, and straight erections (<30 degree curvature) without erectile or ejaculatory problems. Statistics included regression analyses, chi-square/Fisher exact tests and Student's t/Mann-Whitney U and Kruskal-Wallis tests. 

Results: A total of 193 patients and 50 controls participated 16.4 years (range 8.2-21.2) after initial repair. At least 1 reintervention was performed in 39.2%. The highest reintervention rate was found in those younger than 12 months at initial repair, even when excluding proximal hypospadias cases. A disturbed urinary and/or suboptimal sexual functional outcome was seen in 52.9% of cases. Suboptimal voiding was found in 22.1%, although few had relevant residual urine. More reinterventions and proximal hypospadias cases were associated with suboptimal urinary outcome, and the latter also with impaired sexual function. Poor inter-observer agreements were found between physician and patient genital appraisal. 

Conclusions: In 52.9% of cases, at least 1 concern was identified that required long-term followup. Hypospadias repair below 12 months was associated with more reinterventions. Adopting a restrictive attitude toward aesthetic refinement, unless on the patient's own request, could improve urinary outcomes.}},
  author       = {{Tack, Lloyd and Springer, Alexander and Riedl, Stefan and Tonnhofer, Ursula and Hiess, Manuela and Weninger, Julia and Mahmoud, Ahmed and Van Laecke, Erik and Hoebeke, Piet and Cools, Martine and Spinoit, Anne-Françoise}},
  issn         = {{0022-5347}},
  journal      = {{JOURNAL OF UROLOGY}},
  keywords     = {{Urology,hypospadias,treatment outcome,urologic surgical procedures,male,COMPLICATIONS,RISK}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{734--743}},
  title        = {{Adolescent and young adult urogenital outcome following childhood hypospadias repair : perfection revisited}},
  url          = {{http://doi.org/10.1097/ju.0000000000001869}},
  volume       = {{206}},
  year         = {{2021}},
}

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