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Hypospadias management in children with anorectal malformation: a multidisciplinary single center experience

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Abstract

Anorectal malformation (ARM) is often associated to other congenital malformations, requiring a tailored management. Hypospadias’ treatment in ARM is poorly described. Aim of study is to describe our experience in ARM–hypospadias patients especially in relation to occult spinal dysraphism (OSD). ARM patients treated from 1999 to 2022 were retrospectively reviewed, selecting male with hypospadias. Clinical data, hypospadias’s severity, ARM sub-type (Group A: perineal fistula; Group B: urethral fistula, bladder fistula, no fistula), OSD, other associated malformations, NLUTD were evaluated. Exclusion criteria: uncomplete data. Among 395 ARMs, 222 were males, 22 (10%) had hypospadias. Two patients were excluded. Group A: 8 patients, Group-B: 12. Hypospadias: proximal 9 patients, distal 11. Neuro-urological evaluation was performed before hypospadias repair. Eleven patients (55%) had OSD. Four OSD patients presented NLUTD and underwent detethering and CIC (two via cystostomy button, two via appendicostomy); two of them had hypospadias repaired. All proximal hypospadias underwent two stages of surgery. Distal hypospadias was corrected in 4/11 cases. Hypospadias is quite common in ARM patients and its surgical management must be scheduled considering the possible OSD and NLUTD, with the possible need for intermittent catheterization. Complexity of ARM and hypospadias appears to be related to each other.

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Data availability statement

Patients' data are reported in this paper. Other data are available in their clinical charts if necessary.

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Funding

The authors did not receive support from any organization for the submitted work. This manuscript has been viewed and approved by all authors.

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Authors and Affiliations

  1. Division of Neuro-Urology, Bambino Gesu’ Children’s Hospital, IRCCS, Piazza di Sant’Onofrio, 4, 00165, Rome, RM, Italy

    Valentina Forlini, Chiara Pellegrino, Maria Luisa Capitanucci, Beatrice Turchi, Marco Agamennone & Giovanni Mosiello

  2. Pediatric Surgery, University of Genoa, DINOGMI, Largo Paolo Daneo, 3, 16132, Genoa, GE, Italy

    Valentina Forlini & Marco Agamennone

  3. Neonatal Surgery Unit, Bambino Gesu’ Children’s Hospital, IRCCS, Piazza di Sant’Onofrio, 4, 00165, Rome, RM, Italy

    Federico Beati, Barbara Daniela Iacobelli & Andrea Conforti

  4. Division of Physical Rehabilitation, University of Tor Vergata, Via Cracovia, 50, 00133, Rome, RM, Italy

    Maria Laura Sollini

  5. Urology Unit, Ospedale Sant’Andrea, ‘Sapienza’ University of Rome, Via di Grottarossa, 1035/1039, 00189, Rome, RM, Italy

    Beatrice Turchi

  6. Neurosurgery Unit, Bambino Gesu’ Children’s Hospital, IRCCS, Piazza di Sant’Onofrio, 4, 00165, Rome, RM, Italy

    Carlo Efisio Marras, Giacomo Esposito & Paolo Palma

  7. Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children’s Hospital, IRCCS, 00165, Rome, Italy

    Gessica Della Bella & Rossella D’urzo

  8. Neurorehabilitation Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165, Rome, Italy

    Enrico Castelli

  9. Neonatal Surgery Unit, Area of Fetal, Neonatal and Cardiological Sciences, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy

    Pietro Bagolan

Authors
  1. Valentina Forlini
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  2. Chiara Pellegrino
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  3. Maria Luisa Capitanucci
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  4. Federico Beati
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  5. Barbara Daniela Iacobelli
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  6. Andrea Conforti
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  7. Maria Laura Sollini
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  8. Beatrice Turchi
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  9. Marco Agamennone
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  10. Carlo Efisio Marras
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  11. Giacomo Esposito
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  15. Enrico Castelli
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  16. Pietro Bagolan
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  17. Giovanni Mosiello
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Contributions

Conceptualization: GM, CEM. Methodology: MLC, GE, BDI. Formal analysis and investigation: FB, BT, MA, MLS. Writing—original draft preparation: CP, VF, RD’U. Writing—review and editing: AC, PP, GDB. Supervision: PB, EC, GM.

Corresponding author

Correspondence to Chiara Pellegrino.

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The authors have no relevant financial or non-financial interests to disclose. The authors have no competing interests to declare that are relevant to the content of this article.

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Forlini, V., Pellegrino, C., Capitanucci, M.L. et al. Hypospadias management in children with anorectal malformation: a multidisciplinary single center experience. Pediatr Surg Int 39, 226 (2023). https://doi.org/10.1007/s00383-023-05505-y

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