title: Current practice in paediatric hypospadias surgery; a specialist survey.
abstract: OBJECTIVE
  To undertake an online survey of current hypospadias surgery practice among those specialists attending the IVth World Congress of the International Society for Hypospadias and Disorders of Sex Development (ISHID), 2011.
  
  
  METHODS
  An online survey covering 22 separate questions relating to proximal and distal hypospadias surgery was set up, and all delegates registered for the conference were invited to complete this questionnaire anonymously. The data was analysed by three of the authors.
  
  
  RESULTS
  A total of 162 delegates registered for the conference of whom 74% were paediatric surgeons, paediatric urologists, plastic surgeons and adult/adolescent urologists. 93 delegates completed the online survey, and most of them (57%) were from Europe. The majority of surgeons see over 20 new patients/year (90%) and perform primary hypospadias surgery in over 20 patients/year (76%). The tubularized incised plate (TIP) repair is the most frequent technique used for the management of distal hypospadias (59%); other techniques used included Mathieu, onlay and TIP with graft. A variety of techniques are used for proximal hypospadias, but nearly half of the respondents (49%) preferred a staged approach. Self reported complication rates for distal hypospadias surgery are favourable (less than 10%) for 78% of the respondents. However, proximal hypospadias complication rates are higher.
  
  
  CONCLUSIONS
  With a majority of paediatric urologists and European delegates responding to our survey, the results suggest that there are differences in the management of proximal and distal hypospadias between surgeons, yet no differences were observed according to the region of their practice. Variations in long-term outcomes appear to be in keeping with the current literature.
authors.affiliation: Department of Paediatric Urology, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London WC1N 3JH, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Steven
authors.forename: Abraham
authors.initials: A
authors.lastname: Cherian
authors.forename: Francisca
authors.initials: F
authors.lastname: Yankovic
authors.forename: Azad
authors.initials: A
authors.lastname: Mathur
authors.forename: Milind
authors.initials: M
authors.lastname: Kulkarni
authors.forename: Peter
authors.initials: P
authors.lastname: Cuckow
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D012734:Disorders of Sex Development / Q000453:epidemiology / Q000601:surgery*; D019538:Health Care Surveys; D006801:Humans; D007021:Hypospadias / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D010372:Pediatrics; D011183:Postoperative Complications / Q000453:epidemiology; D011364:Professional Practice; D019651:Plastic Surgery Procedures / Q000379:methods* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013521:Urologic Surgical Procedures, Male / Q000379:methods* / Q000706:statistics & numerical data; D014572:Urology
keywords: Hypospadias; Surgical technique; Survey