title: Analysis of risk factors for glans dehiscence after tubularized incised plate hypospadias repair.
abstract: OBJECTIVE
  We determined the incidence of glans dehiscence and the associated risk factors after tubularized incised plate hypospadias repair.
  
  
  METHODS
  All data for patients undergoing tubularized incised plate hypospadias repair, surgical details and postoperative outcomes were prospectively maintained in databases. Data were analyzed with simple and multiple logistic regression to determine if patient age, preoperative testosterone use, meatal location (distal, mid shaft or proximal), glansplasty sutures (chromic catgut vs polyglactin) or primary vs revision tubularized incised plate procedure was associated with an increased risk of glans dehiscence.
  
  
  RESULTS
  Glans dehiscence occurred in 32 of 641 patients (5%). Age at surgery, preoperative testosterone use and glansplasty suture did not impact the risk of glans dehiscence. Glans dehiscence occurred in 20 of 520 distal (4%), 1 of 47 mid shaft (2%) and 11 of 74 proximal (15%) tubularized incised plate repairs, with the odds of glans dehiscence being 3.6 times higher in patients with proximal vs distal meatal location. Patients undergoing reoperative (9 of 64, 14%) vs primary tubularized incised plate (23 of 577, 4%) had a 4.7-fold increased risk of glans dehiscence.
  
  
  CONCLUSIONS
  Proximal meatal location and revision surgery, most commonly for prior glans dehiscence, increase the odds of glans dehiscence by 3.6 and 4.7-fold, respectively, suggesting anatomical and/or host factors (wound healing) are more important than age, type of suture or preoperative testosterone use in the development of this postoperative complication.
authors.affiliation: Pediatric Urology Section, University of Texas Southwestern Medical Center, Dallas, Texas 75207, USA. warren.snodgrass@childrens.com
authors.forename: Warren
authors.initials: W
authors.lastname: Snodgrass
authors.forename: Nicholas
authors.initials: N
authors.lastname: Cost
authors.forename: Paul A
authors.initials: PA
authors.lastname: Nakonezny
authors.forename: Nicol
authors.initials: N
authors.lastname: Bush
mesh_terms: D019540:Area Under Curve; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D015994:Incidence; D007223:Infant; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D012086:Reoperation; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000453:epidemiology*; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods*