Outcome after Hypospadias Repair: Evaluation Using the Hypospadias Objective Penile Evaluation Score

Abstract

Introduction The Hypospadias Objective Penile Evaluation Score (HOPE-Score) is a concise and reproducible way to describe hypospadias severity. We classified boys undergoing primary hypospadias repair to determine the correlation between the HOPE-Score and the severity of hypospadias first and the outcome after surgery second.

Materials and Methods Patients who underwent primary hypospadias repair from 2005 to 2014 were identified. An independent physician assessed retrospectively the HOPE-Score, using photographies of the patients before, after primary surgery, and after all necessary surgeries. The correlation between the HOPE-Score and the severity of hypospadias, on the one hand, and the outcome after surgery, on the other hand, were analyzed.

Results The HOPE-Score was assessed preoperatively for 79 boys, postoperatively for 66, and after all necessary surgeries for 21 patients. Mean HOPE-Score reached 30.2 ± 5.9 before surgery, 42.2 ± 6.1 after primary surgery, and 43.7 ± 3.4 after all necessary surgeries. A significant correlation between the HOPE-Score and the severity of hypospadias before surgery was observed. The boys with glanular hypospadias scored significantly higher (36.3 ± 5.4) than those with distal (29.6 ± 4.4) and proximal hypospadias (21.1 ± 3.5). Furthermore, a significant correlation between the HOPE-Score and the outcome after hypospadias repair was observed. Patients who needed no reintervention after primary hypospadias repair scored significantly higher postoperatively (45.1 ± 5.4) than those who needed a second (40.8 ± 4.2) or more than two surgeries (36.9 ± 7.4).

Conclusion The HOPE-Score is a good system to assess the severity of hypospadias and the cosmetic outcome after hypospadias repair.

Keywords

hypospadias - HOPE-Score - assessment - outcome

• References

• 1 Bergman JE, Loane M, Vrijheid M. , et al. Epidemiology of hypospadias in Europe: a registry-based study. World J Urol 2015; 33 (12) 2159-2167
• 2 Hadidi AT. Classification of hypospadias. In: Hadidi AT, Azmy AF. , eds. Hypospadias Surgery: An Illustrated Guide. Heidelberg, Germany: Springer Verlag; 2004: 79-82
• 3 Duckett JW, Baskin LS. Hypospadias. In: Gillenwater JY, Grayhack JT, Howards SS, Duckett JW. , eds. Adult and Pediatric Urology. 3rd ed. St. Louis, MO: Mosby; 1996: 3
• 4 Tugtepe H, Thomas DT, Kandirici A, Yener S, Dagli T. Should we routinely test for chordee in patients with distal hypospadias?. Eur J Pediatr Surg 2015; 25 (02) 195-198
• 5 Turial S, Enders J, Engel V, Schier F. Stent-free tubularized incised plate (TIP) repair of distal and mid-shaft hypospadias irrespective of age. Eur J Pediatr Surg 2011; 21 (03) 168-170
• 6 van der Toorn F, de Jong TPVM, de Gier RPE. , et al. Introducing the HOPE (Hypospadias Objective Penile Evaluation)-score: a validation study of an objective scoring system for evaluating cosmetic appearance in hypospadias patients. J Pediatr Urol 2013; 9 (6 Pt B): 1006-1016
• 7 Ekmark AN, Svensson H, Arnbjörnsson E, Hansson E. Postpubertal examination after hypospadias repair is necessary to evaluate the success of the primary reconstruction. Eur J Pediatr Surg 2013; 23 (04) 304-311
• 8 Esposito C, Savanelli A, Escolino M. , et al. Preputioplasty associated with urethroplasty for correction of distal hypospadias: a prospective study and proposition of a new objective scoring system for evaluation of esthetic and functional outcome. J Pediatr Urol 2014; 10 (02) 294-299
• 9 Ahmed SF, Dobbie R, Finlayson AR. , et al. Prevalence of hypospadias and other genital anomalies among singleton births, 1988-1997, in Scotland. Arch Dis Child Fetal Neonatal Ed 2004; 89 (02) F149-F151
• 10 Aho M, Koivisto AM, Tammela TL, Auvinen A. Is the incidence of hypospadias increasing? Analysis of Finnish hospital discharge data 1970–1994. Environ Health Perspect 2000; 108 (05) 463-465
• 11 Nissen KB, Udesen A, Garne E. Hypospadias: prevalence, birthweight and associated major congenital anomalies. Congenit Anom (Kyoto) 2015; 55 (01) 37-41
• 12 Holland AJ, Smith GH, Ross FI, Cass DT. HOSE: an objective scoring system for evaluating the results of hypospadias surgery. BJU Int 2001; 88 (03) 255-258
• 13 Weber DM, Schönbucher VB, Landolt MA, Gobet R. The Pediatric Penile Perception Score: an instrument for patient self-assessment and surgeon evaluation after hypospadias repair. J Urol 2008; 180 (03) 1080-1084 , discussion 1084
• 14 Weber DM, Landolt MA, Gobet R, Kalisch M, Greeff NK. The Penile Perception Score: an instrument enabling evaluation by surgeons and patient self-assessment after hypospadias repair. J Urol 2013; 189 (01) 189-193
• 15 Merriman LS, Arlen AM, Broecker BH, Smith EA, Kirsch AJ, Elmore JM. The GMS hypospadias score: assessment of inter-observer reliability and correlation with post-operative complications. J Pediatr Urol 2013; 9 (6 Pt A): 707-712
• 16 Springer A. Assessment of outcome in hypospadias surgery—a review. Front Pediatr 2014; 2: 2
• 17 Hueber P-A, Antczak C, Abdo A, Franc-Guimond J, Barrieras D, Houle A-M. Long-term functional outcomes of distal hypospadias repair: a single center retrospective comparative study of TIPs, Mathieu and MAGPI. J Pediatr Urol 2015; 11 (02) 68.e1-68.e7
• 18 Hardwicke JT, Bechar JA, Hodson J, Osmani O, Park AJ. Fistula after single-stage primary hypospadias repair—a systematic review of the literature. J Plast Reconstr Aesthet Surg 2015; 68 (12) 1647-1655
• 19 Khan M, Majeed A, Hayat W. , et al. Hypospadias repair: a single centre experience. Plast Surg Int 2014; 2014: 453039
• 20 Schneuer FJ, Holland AJA, Pereira G, Bower C, Nassar N. Prevalence, repairs and complications of hypospadias: an Australian population-based study. Arch Dis Child 2015; 100 (11) 1038-1043
• 21 Malone P. Meatal stenosis and urethral strictures after hypospadias surgery. In: Hadidi AT, Azmy AF. , eds. Hypospadias Surgery: An Illustrated Guide. Heidelberg, Germany: Springer Verlag; 2004: 295-300
• 22 Lacy JM, Hendrix LN, Bole R, Habib E, Wootton CW, Ziada AM. Technical refinements to improve outcomes following distal hypospadias repair. Can J Urol 2016; 23 (01) 8184-8187