Journal of Plastic, Reconstructive & Aesthetic Surgery
The UK primary hypospadias surgery audit 2006–2007☆
Section snippets
Materials and methods
A one-page proforma for data was drafted and then made shorter and simpler to complete with the help of paediatric urology colleagues, in particular Stuart O'Toole, at that time the Secretary of BAPU.
On the proforma surgeons had to give numbers of the types of hypospadias treated, e.g glanular, subcoronal, etc., the types and numbers of primary hypospadias operations, e.g. meatotomy, Snodgrass TIP, Ist stage Bracka, 2nd stage Bracka, and the ages of the patients at primary surgery (less than
Results
There were 50 replies from paediatric surgeons/urologists (n = 24) and plastic surgeons (n = 26) and one from a urologist (an overall response of 53%, 79% of plastic surgeons and 40% of paediatric surgeons).
Most of the patients treated by the paediatric surgeons, the plastic surgeons and the urologist had some form of distal hypospadias.
The paediatric surgeons reported nearly twice as many operations (n = 814) as the plastic surgeons (n = 436). The urologist reported five operations.
There was also a
Discussion
This prospective audit shows the extent and variety of primary hypospadias surgery in the UK in 2006–2007.
The limitations and weaknesses of the audit are obvious. For example, only surgeons on the UK Register of Hypospadias Surgeons were asked to participate. It is possible that there are other surgeons not on the register who carry out primary hypospadias surgery, for example in the private sector outside the UK National Health Service. In addition, only 53% of registered surgeons took part in
The future
Low volume operators and those who routinely carry out primary hypospadias surgery in children after the age of two years should change their practice.
To help surgeons to make informed choices about the types of operations to use, prospective outcome studies are needed to provide more information.
In the UK, there is concern about the number of surgeons trained to carry out paediatric surgery and the future provision of paediatric surgery.9 All specialities who carry out hypospadias surgery
Acknowledgement
On behalf of BAPU, BAPS and BAPRAS I wish to thank all those who took part in this audit.
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Cited by (7)
Medium to long term results following single stage Snodgrass hypospadias repair
2013, Journal of Plastic, Reconstructive and Aesthetic SurgeryCitation Excerpt :The tubularised incised plate technique, as a one-stage procedure for distal hypospadias, was initially described by Orkiszewski4 as a salvage procedure in 1987 and popularized by Snodgrass in 1994.5 In the UK primary hypospadias surgery audit 2006–7, it was found to be the most common procedure performed for distal hypospadias repair.2 It involves tubularisation of the dorsally incised urethral plate without the need for skin flaps or grafts.
Trends in hypospadias surgery: Results of a worldwide survey
2011, European UrologyCitation Excerpt :Others have taken >20 operations per year as a criterion for a high-volume surgeon. However, what exactly constitutes a high-volume operator is a matter of discussion [9]. No prospective trials so far have defined a clear cut-off.
Management of hypospadias in Saudi Arabia: A national survey
2018, Urology AnnalsReconstructive surgery for hypospadias: A systematic review of long-term patient satisfaction with cosmetic outcomes
2016, Indian Journal of UrologyTiming of hypospadias repair in patients with disorders of sex development
2014, Endocrine Development
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Presented at the International Meeting on Hypospadias Surgery, Coventry, UK, May 2009.