title: [Erythropoietin before severe hypospadias repair: fewer complications?].
abstract: OBJECTIVE
  To study the effect of a preparation by erythropoietin before Onlay's intervention on postoperative hematocrits and medium-term results of the surgery.
  
  
  METHODS
  Twenty-one patients were operated on by Onlay's technique between 2001 January and 2008 September, after being treated by erythropoietin. Seven had a midshaft hypospadias, two a posterior hypospadias and 12 a penoscrotal hypospadias. All children were examinated four months after surgery to evaluate the surgical results.
  
  
  RESULTS
  After the surgery, 18 children had an apical meatus (85.7%). Three had a balanopreputial meatus, two a stenosis of the meatus. Two children were reoperated on, one with the Duplay's technique, the other for a meatostomy. No fistula, no necrosis of the preputial flap was observed. The preoperative hematocrit was measured at 41%, with an increase of 3.8% because of the preparation. Peroperative blood loss was evaluated at 6.6%. After surgery, 12 children had an hematocrit inferior than 35%, four an hematocrit inferior than 30%. No transfusion was needed.
  
  
  CONCLUSIONS
  Preparation by erythropoietin before severe hypospadias surgery seemed to have several advantages: a more elevated hematocrit after surgery than with an iron preparation alone, and a lower rate of postoperative complications, including fistulas and necrosis of the preputial flap.
authors.affiliation: Clinique chirurgicale infantile, hôpital Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France. mariette.petel@etu.univ-rouen.fr
authors.forename: M
authors.initials: M
authors.lastname: Renaux-Petel
authors.forename: D
authors.initials: D
authors.lastname: Comte
authors.forename: M
authors.initials: M
authors.lastname: Beurdeley
authors.forename: A
authors.initials: A
authors.lastname: Liard-Zmuda
mesh_terms: D004921:Erythropoietin / Q000627:therapeutic use*; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011300:Preoperative Care; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects
chemical_list: D004921:Erythropoietin