Eur J Pediatr Surg
DOI: 10.1055/s-0037-1599230
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Complications after Hypospadias Correction: Prognostic Factors and Impact on Final Clinical Outcome

Elisabeth Maria Dokter
Department of Plastic Surgery and Hand Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
,
Chantal M. Mouës
Department of Plastic Surgery and Hand Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
,
Iris A. L. M. van Rooij
Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
,
Jan Jaap van der Biezen
Department of Plastic Surgery and Hand Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
› Author Affiliations
Further Information

Publication History

17 November 2016

17 January 2017

Publication Date:
17 March 2017 (eFirst)

Abstract

Purpose The purpose of this study was to analyze the influence of patient and treatment characteristics on the occurrence of complications after hypospadias correction and the impact of complications on final clinical outcome.

Methods The study cohort consisted of 205 hypospadias patients who had surgery in the Medical Centre Leeuwarden (1996–2011). Patient and treatment characteristics were hypospadias severity (preoperative meatal location and chordee), number of planned surgeries, reconstruction technique, operation year, and patient's age at the time of surgery. The final clinical outcome was measured with the Hypospadias Objective Scoring Evaluation (HOSE) (maximum score = 16) and compared between patients with and without complications.

Results Sixty-four patients (31%) had complications, most of which were fistulas (n = 40). An increased complication risk was seen in patients with severe hypospadias (preoperative proximal meatus or chordee), multistage reconstruction, reconstruction techniques other than Mathieu, and surgeries performed before 2005. Uncomplicated treatment resulted only in a marginally higher HOSE (15.7) compared with complicated treatment (15.4). Fistulas and multiple complications reduced clinical outcome more (15.3 and 14.9, respectively), while urinary tract infections, wound dehiscence, or prepuce related complications did not (16.0, 16.0, and 15.8, respectively).

Conclusion The complication risk after hypospadias correction is influenced by hypospadias severity and type and year of reconstruction. Certain, but not all complications diminish final clinical outcome.