Our Summary

This research paper looks at whether a scoring tool called the Plate Objective Scoring Tool (POST), which measures the configuration of the urethral plate in boys with a condition called distal hypospadias, can predict the risk of complications after surgery.

The researchers collected data from boys who had surgery for hypospadias between 2020 and 2023, and found that the POST scores were strongly linked to the likelihood of complications after the surgery.

They found that a POST score of 1.2 was the best predictor of risk of post-operative complications. If a patient had a POST score of 1.2 or higher, they had a 4.4% chance of complications, whereas if their score was less than 1.2, their risk was 25%.

In conclusion, the researchers believe that the POST score can act as a useful tool for assessing the quality of the urethral plate and predicting the success of hypospadias surgery. This could help doctors to identify which patients need closer monitoring after surgery.

FAQs

  1. What is the Plate Objective Scoring Tool (POST) used for in the context of hypospadias?
  2. How is the POST score linked to the likelihood of post-operative complications in hypospadias surgery?
  3. How can the POST score help doctors in managing patients who have undergone hypospadias surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hypospadias repair is to ask about the Plate Objective Scoring Tool (POST) and the importance of monitoring the configuration of the urethral plate before and after surgery. Patients with a POST score of 1.2 or higher may have a lower risk of complications, while those with a score below 1.2 may need closer monitoring. It is important for patients to discuss their POST score with their doctor and follow any recommended post-operative care instructions to optimize their outcomes.

Suitable For

Patients with distal hypospadias, where the opening of the urethra is located near the tip of the penis, are typically recommended for hypospadias repair. Additionally, patients with complications such as chordee (bending of the penis), meatal stenosis (narrowing of the urethral opening), or urethrocutaneous fistula (abnormal connection between the urethra and skin) may also be recommended for hypospadias repair.

Other factors that may influence the recommendation for hypospadias repair include the age of the patient, the severity of the hypospadias, the presence of associated conditions such as undescended testes or hypospadias-associated complications, and the overall health of the patient.

Ultimately, the decision to undergo hypospadias repair is made on a case-by-case basis by a urologist or pediatric surgeon, taking into consideration the individual patient’s unique circumstances and needs.

Timeline

Before hypospadias repair:

  • Patient is diagnosed with hypospadias, a congenital condition where the opening of the urethra is on the underside of the penis.
  • Patient undergoes pre-operative assessments and consultations with the surgical team.
  • Surgery is scheduled and patient and their family are briefed on the procedure and post-operative care.

After hypospadias repair:

  • Patient undergoes surgery to correct the position of the urethral opening.
  • Patient is monitored closely in the immediate post-operative period for any signs of complications such as infection or bleeding.
  • Patient may experience pain, swelling, and discomfort in the days following surgery.
  • Patient is discharged from the hospital with instructions for wound care and follow-up appointments.
  • Over the following weeks and months, patient continues to be monitored for any long-term complications or issues with the surgical repair.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hypospadias repair include:

  1. What is the Plate Objective Scoring Tool (POST) and how is it used in assessing the configuration of the urethral plate for boys with hypospadias?
  2. How does my POST score impact the likelihood of complications after surgery?
  3. What is my specific POST score and what does it indicate about my risk for post-operative complications?
  4. Are there any additional factors that may affect my risk for complications after hypospadias surgery?
  5. How will my POST score be used to tailor my post-operative care and follow-up?
  6. What are the potential complications that could arise after hypospadias surgery and how will they be managed?
  7. How often should I follow up with my doctor after surgery to monitor for any complications?
  8. Are there any specific signs or symptoms I should watch for that may indicate a complication?
  9. How will my POST score impact the long-term success of the surgery and any potential need for additional procedures in the future?
  10. Are there any lifestyle changes or precautions I should take to reduce my risk of complications after hypospadias repair?

Reference

Authors: Abbas TO, Khalil IA, Hatem M, Boyko A, Zorkin S. Journal: J Pediatr Urol. 2024 Apr;20(2):238.e1-238.e6. doi: 10.1016/j.jpurol.2023.11.022. Epub 2023 Nov 25. PMID: 38071112