Abstract:
BACKGROUND:There is an ongoing quest on how to minimize complications in hypospadias surgery. There is however a lack of high-quality data on the following parameters that might influence the outcome of primary hypospadias repair: age at initial surgery, the type of suture material, the initial technique, and the type of hypospadias. OBJECTIVES:The objective of this study was to identify independent predictors for re-intervention in primary hypospadias repair. STUDY DESIGN:We retrospectively analyzed our database of 474 children undergoing primary hypospadias surgery. Univariate and multivariate logistic regression was performed to identify variables associated with re-intervention. A p-value <0.05 was considered statistically significant and therefore considered as a prognostic factor for re-intervention. RESULTS:Distal penile hypospadias was reported in 77.2% (n = 366), midpenile in 11.4% (n = 54) and proximal in 11.4% (n = 54) of children. Initial repair was based on an incised plate technique in 39.9% (n = 189), meatal advancement in 36.0% (n = 171), an onlay flap in 17.3% (n = 82) and other or combined techniques in 5.3% (n = 25). In 114 patients (24.1%) re-intervention was required (n = 114) of which 54 re-interventions (47.4%) were performed within the first year post-surgery, 17 (14.9%) in the second year and 43 (37.7%) later than 2 years after initial surgery. The reason for the first re-intervention was fistula in 52 patients (46.4%), meatal stenosis in 32 (28.6%), cosmesis in 35 (31.3%) and other in 14 (12.5%). The median time for re-intervention was 14 months after surgery [range 0-114]. Significant predictors for re-intervention on univariate logistic regression (polyglactin suture material versus poliglecaprone, proximal hypospadias, lower age at operation and other than meatal advancement repair) were put in a multivariate logistic regression model. Of all significant variables, only proximal hypospadias remained an independent predictor for re-intervention (OR 3.27; p = 0.012). DISCUSSION:The grade of hypospadias remains according to our retrospective analysis the only objective independent predicting factor for re-intervention in hypospadias surgery. This finding is rather obvious for everyone operating hypospadias. Curiously midpenile hypospadias cases were doing slightly better than distal hypospadias in terms of re-intervention rates. Our study however has also some shortcomings. First of all, data was gathered retrospectively and follow-up time was ill-balanced for several variables. We tried to correct this by applying sensitivity analysis, but possible associations between some variables and re-intervention might still be obscured by this. Standard questionnaires to analyze surgical outcome were not available. Therefore, we focused our analysis on re-intervention rate as this is a hard and clinically relevant end point. CONCLUSIONS:This retrospective analysis of a large hypospadias database with long-term follow-up indicates that the long-lasting debate about factors influencing the reoperation rate in hypospadias surgery might be futile: in experienced hands, the only variable that independently predicts for re-intervention is the severity of hypospadias, the only factor we cannot modify. This retrospective multivariate analysis of a large hypospadias database with long-term follow-up suggests that the only significant independent predictive factor for re-intervention is proximal hypospadias. In our series, technique did not influence the re-intervention rate.
journal_name
J Pediatr Uroljournal_title
Journal of pediatric urologyauthors
Spinoit AF,Poelaert F,Van Praet C,Groen LA,Van Laecke E,Hoebeke Pdoi
10.1016/j.jpurol.2014.11.014subject
Has Abstractpub_date
2015-04-01 00:00:00pages
70.e1-6issue
2eissn
1477-5131issn
1873-4898pii
S1477-5131(15)00013-3journal_volume
11pub_type
杂志文章abstract:INTRODUCTION:Extensive skin bridging with replacement of glans epithelium by shaft skin is an unusual complication of newborn circumcision not previously described. MATERIALS AND METHODS:Patients with extensive skin bridges and replacement of at least 50% of glans epithelium with shaft skin underwent lysis of the brid...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2006.01.010
更新日期:2006-12-01 00:00:00
abstract:INTRODUCTION:Long-term outcomes are of special concern in children after urinary diversion. In a single institution study we evaluated retrospectively the long-term outcomes of urinary diversion in children, in whom the ileocecal segment had been used, in respect to complications of the efferent segment. METHODS:The M...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.05.008
更新日期:2016-08-01 00:00:00
abstract::Although some centres have successfully integrated remote clinics into their paediatric urological practice, for many, remote clinics have developed due to the COVID-19 pandemic. One UK-based institution has integrated remote clinics in their practice for over two years and has developed guidelines considering which c...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2021.01.001
更新日期:2021-01-06 00:00:00
abstract:BACKGROUND:Lower urinary tract dysfunction (LUTD) is a broad term describing the full spectrum of disorders in any of the stages of bladder function-storage or voiding LUTD is a clinical condition associated with emotional and behavioral disorders in children. This cross-sectional study aimed to investigate the associa...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.07.017
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To determine the changes in number and morphology of interstitial cells of Cajal (ICC)-like cells (ICC-LC) at the ureteropelvic junction (UPJ) of rats after experimental distal ureteral obstruction. MATERIALS AND METHODS:Of a total of 109 rats, 20 served as controls (C), 20 underwent sham-operations (SH) and...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2008.12.006
更新日期:2009-08-01 00:00:00
abstract:INTRODUCTION:Prenatal determination of bladder exstrophy (BE) or cloacal exstrophy (CE), known also as the omphalocele-exstrophy-imperforate anus-spinal anomaly complex (OEIS), is challenging. Distinguishing between BE and CE is important because children with CE have many more challenges initially and during their lif...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.07.024
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:As robotic-assisted surgery becomes increasingly utilized for pediatric ureteropelvic junction (UPJ) obstruction, open surgeons have countered by using muscle-splitting, miniature (≤2 cm) incisions. To prepare for this type of incision during pyeloplasty, it is necessary to define the exact location of the...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.04.022
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Urethral stricture presents an uncommon but difficult urological problem in the pediatric population. Treatment protocols are different from in adults due to anatomical considerations. MATERIAL AND METHODS:A thorough manual and Medline search was conducted to review the existing literature on post-traumatic...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2011.06.004
更新日期:2012-06-01 00:00:00
abstract:INTRODUCTION:Bladder Exstrophy and Epispadias Complex (BEEC) is associated with an increased risk of impaired mental health, quality of life, and psychosocial functioning. Therefore, screening patients to help identify and evaluate potential psychosocial difficulty is arguably an important consideration for BEEC Servic...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.10.013
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:Bladder spasms are a common cause of pain after surgical procedures that call for postoperative catheter drainage. Several therapeutic methods have been used to lessen these spasms but none have received widespread success. PATIENTS AND METHODS:Twenty-six children were included in a prospective randomized tr...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2006.11.003
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:Iatrogenic ureteral injury in children is a rare occurrence, with sparse literature available regarding optimal repair techniques. We reviewed our experience in the management of iatrogenic pediatric ureteral injuries, particularly with respect to initial versus delayed diagnoses. METHODS:All pediatric iatro...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2008.08.004
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Estimation of the quality of the urethral plate (UP) seems to be important when assessing postoperative outcomes of hypospadias repair, but its evaluation remains subjective. We developed an objective model aiming to standardize this assessment, proposing a methodology that could be adopted in future studies...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.07.043
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:Primary nocturnal enuresis is one of the sleep related phenomena characterized by disruption in the relationship between arousal and urination. Corticotropin-releasing factor (CRF) is a neurohormone released from the paraventricular nucleus of the hypothalamus into the median eminence to elicit release of ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.08.030
更新日期:2017-02-01 00:00:00
abstract:PURPOSE:Intestinal bladder augmentation predisposes the patient to many complications. The aim of this study was to determine whether augmentation has an adverse effect on growth. MATERIALS AND METHODS:Longitudinal growth data were collected and analyzed for nine patients with bladder exstrophy and augmentation, and c...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2007.07.002
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:To report our experience with laparoscopic transperitoneal (TP) heminephrectomy for duplicated pyeloureteral systems in children under 2 years old. PATIENTS AND METHODS:We retrospectively reviewed the intraoperative evolution and patient outcome of 10 laparoscopic partial ureteronephrectomies (7 upper and 3 ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2009.06.012
更新日期:2010-04-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:Female pediatric patients with continuous drip incontinence present a diagnostic challenge. At times, these symptoms may be due to an ectopic ureter inserting below the external sphincter. The evaluation may consist an ultrasound and voiding cystourethrogram (VCUG), but these may not be diagn...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2005.06.009
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:Prompt diagnosis and treatment of paediatric urolithiasis are required to avoid long term sequelae of renal damage. OBJECTIVE:To systematically review the literature regarding the diagnostic imaging modalities and treatment approaches for paediatric urolithiasis. STUDY DESIGN:PubMed, Science Direct, Scopus...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2020.07.003
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:Seven percent of patent processus vaginalis (PPVs) are obliterated at exploration. This potentially increases the risk of cord injury with a subsequent increased risk of testicular atrophy or reduced fertility. We report a modification of a technique to improve identification of the PPV and thus potentially m...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2007.08.008
更新日期:2008-06-01 00:00:00
abstract:INTRODUCTION:Bladder calculi are a known complication of bladder augmentation. Open cystolithotomy remains the preferred option for treating large or multiple stones. Increasingly, however, minimal access techniques have been used. Reports of Mitrofanoff cystolitholapaxy are rare and have been limited to adults. This s...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpurol.2018.02.024
更新日期:2018-10-01 00:00:00
abstract:INTRODUCTION:Management of poorly functioning kidneys with ureteropelvic junction obstruction (UPJO) is controversial, with some recommending direct nephrectomy and others direct pyeloplasty, and others temporary diversion. This study aimed to determine whether pyeloplasty is associated with higher complication rate th...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpurol.2019.05.032
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of VQZ plasty, we analyzed our experience with continent catheterizable urinary stomas using VQZ plasty and V-flap techniques. PATIENTS AND METHODS:We retrospectively reviewed the records of 25 patients who underwent Mitrofanoff procedures in 2000-2009. All stomas were created i...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2010.05.012
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Post-ablation urethral strictures are a rare but devastating complication following transurethral ablation of posterior urethral valve which can be more difficult to treat than the valve itself. Though with the miniaturization of scopes the incidence of these strictures has decreased, sadly they still contin...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.09.001
更新日期:2020-12-01 00:00:00
abstract::This review of bladder diverticula in children includes: historical aspects of the condition, its presentation and diagnosis, as well as management options. The purpose of the review is to provide a comprehensive and in-depth understanding of a relatively infrequent but clinically challenging urologic abnormality that...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2012.02.013
更新日期:2013-04-01 00:00:00
abstract:PURPOSE:The aim of this study is to investigate in Turkish boys the emotional effects of hypospadias repair before and after the optimal age for repair. MATERIALS AND METHODS:Forty hypospadias patients treated in our department were included in this study. Group 1 consisted of 13 patients operated on at less than 30 m...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2004.12.003
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVE:Voiding disorders are commonly encountered in paediatric urology practice. Urinary incontinence often leads to the impairment of self-esteem but can also cause renal damage, when recurrent urinary tract infection (UTI) or vesico-ureteral reflux (VUR) exists. The aim of this study was to assess the efficacy of...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2005.09.004
更新日期:2006-10-01 00:00:00
abstract:PURPOSE:To evaluate the efficacy of fibrin sealant for repair of urethrocutaneous fistula after multiple failed hypospadias and epispadias surgeries. MATERIALS AND METHODS:The study population comprised 11 boys (mean age 12.18 years) with history of hypospadias or epispadias and at least two failed fistula repair oper...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2010.06.004
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:There are no clinical reports on the risk of carcinoids in the gastric segment following gastrocystoplasty. The aim of the present study was to examine whether gastric carcinoids could develop in a rat model of gastrocystoplasty. MATERIALS AND METHODS:Rats were subjected to gastrocystoplasty in which 10% of ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2011.01.008
更新日期:2012-04-01 00:00:00
abstract:INTRODUCTION:Many theories have been proposed for the coexistence of constipation and lower urinary tract dysfunction (LUTD), such as bladder compression from a distended rectum and stimulation of sacral reflexes from a full rectum. In these cases, successful treatment of constipation should result in resolution of bla...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2015.05.032
更新日期:2015-12-01 00:00:00
abstract:PURPOSE:Gil-Vernet trigonoplasty is a simple, fast and effective technique for treating primary VUR, and is the only technique used to manage unilateral reflux that does not result in contralateral new reflux, due to its inherent bilateral nature. We have tried to further simplify postoperative management of the proced...
journal_title:Journal of pediatric urology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpurol.2008.06.004
更新日期:2008-12-01 00:00:00
abstract::Isolated congenital megacystis represents a rare variant of fetal megacystis without other associated anomalies. The etiology is unclear, and various management strategies have been proposed. We report a case of isolated congenital megacystis that resolved over the first year of life with observation alone. Considerat...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2012.07.012
更新日期:2013-02-01 00:00:00