Centralisation of a hypospadias repair service--the Warwickshire experience.
An audit of the hypospadias repair service provided in the county of Warwickshire has shown that centralising all referrals to a single surgeon who uses limited, well-practiced techniques, greatly improves outcome. Comparison to previous audit of the service, when provided by a number of surgeons in the region, shows complication rates dropping - fistulae occurrence reducing from 35.8% to 6.7% and urethral stricture rates showing similar improvement from 4.4% to 0%. Overall productivity increased, and referral out of region dropped from 13% to 0%. This provides definitive evidence that restructuring of a service already in place has decreased morbidity and increased efficiency to give results comparable to published data.
Hardwicke
J
J
George Eliot Hospital, Nuneaton, Warwickshire, United Kingdom. joe_1976@lycos.co.uk
Clarkson
J
J
Park
A
A
D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000209:etiology; D005402:Fistula / Q000209:etiology; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D008485:Medical Audit / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D012017:Referral and Consultation / Q000458:organization & administration*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014521:Urethra / Q000473:pathology; D013521:Urologic Surgical Procedures, Male / Q000379:methods