Analysis of Meatal Location in 500 Men: Wide Variation Questions Need for Meatal Advancement in All Pediatric Anterior Hypospadias Cases

Fichtner, Jan; Filipas, D.; Mottrie, Alexandre; Voges, G.; Hohenfellner, R.

doi:10.1016/s0022-5347(01)67177-5

Cited by 90 publications

(57 citation statements)

References 4 publications

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“…Certainly, it is well established that mild hypospadias does not interfere with fertility, a male's ability to direct his urinary stream or urinate while standing. Fitchtner et al [18] reported a 13% hypospadias rate in a screening of 500 men for meatal location. Indeed, the vast majority of these men (mean age 57 years) were unaware of any abnormality of their phallus.…”

Section: Discussionmentioning

confidence: 99%

The ‘learning curve’ in hypospadias surgery

Horowitz¹,

Salzhauer

2006

BJU International

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OBJECTIVETo provide an insight into the 'learning curve' of fellowship-trained paediatric urologists associated with hypospadias repair, as hypospadias surgery is one of the most common yet difficult procedures used by the paediatric urologist. PATIENTS AND METHODSProspective data were collected on 231 consecutive hypospadias operations performed by one paediatric urologist (M.H.) over a 5-year period, beginning with his first year after completing his fellowship. All patients were having their first surgery and none had a staged repair. Fistula formation was used as a surrogate for the complication rate, as it is an objective measurable outcome that is easily identified with little interobserver or parental/physician variability. The follow-up included several visits in the 15 months after repair, during which virtually all complications could be identified and addressed. RESULTSThe operative results improved throughout the 5 years of observation; there was a statistically significant decline in the fistula rate in each year of observation ( P < 0.001; Kruskal-Wallis exact test for ranked groups). The absolute reduction in fistula rates between the first 2 and the last 2 years was 12.7% ( P < 0.02; chi squared). CONCLUSIONSThe science and surgery of hypospadiology is mostly and correctly delegated to the paediatric urologist. Even in the hands of a fellowship-trained paediatric urologist, a successful repair, as measured by complication rate, statistically improves with time and experience.

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Section: Discussionmentioning

confidence: 99%

The ‘learning curve’ in hypospadias surgery

Horowitz¹,

Salzhauer

2006

BJU International

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“…This is in contrast to a study of adult men with hypospadias evaluated during transurethral surgery, who reported that they could void in a standing position and have sexual intercourse without problems. 63 …”

Section: Functional Outcomes After Hypospadias Repairmentioning

confidence: 99%

Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes

Keays

Davé

2017

CUAJ

110

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“…Different opinions have been expressed as to the necessity for surgery for glanular cases (Fichtner et al 1995), and the proportion of surgically corrected cases in the literature is variable. A Danish study reported 48% of all identified hypospadias cases born 1983-1993 with a record of surgical treatment (Weidner et al 1998).…”

Section: Implementation Of Guideline To Exclude Glanular Casesmentioning

confidence: 99%

“…The influential early Rochester single hospital series (Sweet et al 1974(Sweet et al ) for 1940(Sweet et al -1970 quoted in many pediatric urology and surgery textbooks reported a relatively high prevalence of 4 per 1,000 births but also a high proportion of glanular and coronal cases (87%), suggesting more complete diagnosis of glanular cases and/or a shifted boundary between "normal" and "abnormal." A German study of 500 adult men (Fichtner et al 1995) found that 13% had hypospadias (equivalent to a rate of 65 per 1,000 births), of which 75% had glanular hypospadias, 98% coronal or glanular. It is probable that the high proportion of glanular hypospadias in this study was related to measurement and designation of the "normal/abnormal" boundary in adult men.…”

Section: Implementation Of Guideline To Exclude Glanular Casesmentioning

confidence: 99%

Toward the effective surveillance of hypospadias.

Dolk

Vrijheid

Scott

et al. 2004

Environ Health Perspect

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Concern about apparent increases in the prevalence of hypospadias--a congenital male reproductive-tract abnormality--in the 1960s to 1980s and the possible connection to increasing exposures to endocrine-disrupting chemicals have underlined the importance of effective surveillance of hypospadias prevalence in the population. We report here the prevalence of hypospadias from 1980 to 1999 in 20 regions of Europe with EUROCAT (European Surveillance of Congenital Anomalies) population-based congenital anomaly registers, 14 of which implemented a guideline to exclude glanular hypospadias. We also report data from the England and Wales National Congenital Anomaly System (NCAS). Our results do not suggest a continuation of rising trends of hypospadias prevalence in Europe. However, a survey of the registers and a special validation study conducted for the years 1994-1996 in nine EUROCAT registers as well as NCAS identified a clear need for a change in the guidelines for registration of hypospadias. We recommend that all hypospadias be included in surveillance, but that information from surgeons be obtained to verify location of the meatus, and whether surgery was performed, in order to interpret trends. Investing resources in repeated special surveys may be more cost-effective than continuous population surveillance. We conclude that it is doubtful whether we have had the systems in place worldwide for the effective surveillance of hypospadias in relation to exposure to potential endocrine-disrupting chemicals.

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Analysis of Meatal Location in 500 Men: Wide Variation Questions Need for Meatal Advancement in All Pediatric Anterior Hypospadias Cases

Cited by 90 publications

References 4 publications

The ‘learning curve’ in hypospadias surgery

The ‘learning curve’ in hypospadias surgery

Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes

Toward the effective surveillance of hypospadias.

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