A prospective audit of hypospadias correction in a regional paediatric surgery centre.
OBJECTIVE
To prospectively review the management and treatment of hypospadias in a single regional centre, and in particular, to assess the spectrum of cases treated, techniques used and to determine the nature of the complications.


METHODS
One hundred and fifty-three consecutive boys undergoing hypospadias repair during a 36-month period were included in the study. Information was collected prospectively and included the site of the urethral meatus, presence of chordee, surgical technique employed, use of urinary diversion, and the prescription of postoperative antibiotics and analgesics. Patients were assessed in the clinic following surgery at which time information on outcome and complications was obtained.


RESULTS
One hundred and fifty-seven procedures for hypospadias were performed. Single-stage reconstruction was performed in 145 boys. GRAP (glanular reconstruction and preputioplasty) repair was the most common operation employed (n=112). The overall fistula rate was 11.7 % with the majority of patients having a satisfactory functional and cosmetic outcome following surgery.


CONCLUSIONS
A variety of techniques can be employed to provide satisfactory correction of hypospadias with an increasing emphasis on single-stage day case procedures. GRAP repair is the favoured option for distal hypospadias and incorporates preservation of the prepuce.
Heer
R
R
Department of Paediatric Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK. rakeshheer@hotmail.com
Dorkin
T J
TJ
Byrne
R L
RL
Griffiths
T R L
TR
Rangecroft
L
L
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000473:pathology / Q000601:surgery*; D007223:Infant; D008297:Male; D008485:Medical Audit; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D014548:Urinary Fistula / Q000453:epidemiology; D013520:Urologic Surgical Procedures / Q000379:methods