title: Outcomes of hypospadias repair in older children: a prospective study.
abstract: OBJECTIVE
  The American Academy of Pediatrics recommendation is to perform hypospadias repair at age 6 to 12 months. However, our patient population included a significant proportion of patients in adolescence and beyond undergoing primary repair. We report a comparison of outcomes in patients in different age groups.
  
  
  METHODS
  We prospectively report on patients with distal hypospadias who underwent primary repair at our institution during 7 months. Study parameters included age, degree of hypospadias, surgical technique and the complications rate.
  
  
  RESULTS
  A total of 61 patients were included in analysis. All cases underwent repair using the tubularized incised plate technique. More proximal hypospadias and different repair techniques were excluded from study. Patients were classified by age, including group 1-25 (40%) 6 months to 2 years old, group 2-17 (28%) 2.2 to 3.7 years old and group 3-19 (32%) 4 years old or older. Only 6 patients (9.8%) had postoperative complications and all were in groups 2 and 3. In group 2 there were 3 complications (17.6%), including loss of repair, meatal stenosis and hematoma in 1 case each. In group 3 there were 3 cases (15.8%) of postoperative fistula. The fistula incidence was higher in group 3 (p = 0.032).
  
  
  CONCLUSIONS
  Despite previous reports suggesting a much higher incidence of complications in older children the complication rate is within the acceptable range for infant hypospadias repair in some series. However, these complications were statistically significantly different between the older groups when compared with the recommended age group under American Academy of Pediatrics guidelines.
authors.affiliation: Division of Urology, University of Kentucky, Lexington, KY, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Ziada
authors.forename: Amgad
authors.initials: A
authors.lastname: Hamza
authors.forename: Mohammed
authors.initials: M
authors.lastname: Abdel-Rassoul
authors.forename: Enmar
authors.initials: E
authors.lastname: Habib
authors.forename: Ahmad
authors.initials: A
authors.lastname: Mohamed
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Daw
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods