Our Summary

This research paper is about a medical procedure known as hypospadias repair, which is often performed on boys who have a condition where the opening of the urethra is located on the underside of the penis instead of at the tip. The researchers wanted to know how often boys needed to have this operation done more than once, and if there were any factors that might influence this.

They looked at the medical records of over 5,000 boys who had the operation done between 2009 and 2010, and found that depending on the type of repair done, between 12.6% and 46.6% of boys needed to have the operation done a second time in the next 9 to 10 years.

When they tried to see if there was a connection between needing a second operation and things like the boy’s age, the type of insurance they had, where they lived, and how experienced their surgeon was, they found that boys with noncommercial insurance were 26% more likely to need a second operation. However, there was no link found between needing a second operation and the boy’s age, or the surgeon’s experience or volume of surgeries.

The researchers concluded that the number of boys needing a second operation is likely underreported, and that insurance status is a key factor in whether or not a boy might need a second operation. They also found that age, surgeon’s experience, and the number of surgeries a surgeon performs have no impact on whether a boy might need a second operation.

FAQs

  1. What is the reported reoperation rate after distal hypospadias repair?
  2. What factors were found to be associated with secondary hypospadias surgery rates?
  3. What was the impact of insurance type on the odds of secondary hypospadias surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hypospadias repair is to ensure they have appropriate insurance coverage in place, as noncommercial insurance was found to be associated with a higher likelihood of needing secondary surgery. It is important to have regular follow-up appointments with their healthcare provider to monitor for any potential complications and address them promptly.

Suitable For

Patients who undergo primary hypospadias repair are typically recommended for secondary surgery if they experience complications or unsatisfactory outcomes from the initial procedure. The study mentioned in the abstract found that secondary surgery rates were higher for proximal and perineal hypospadias repair compared to distal repair. Patients with noncommercial insurance were also found to have a higher likelihood of requiring secondary surgery. Additionally, age, surgeon volume, and experience were not found to be significant factors in predicting the need for secondary surgery. Overall, patients who experience complications or have unsatisfactory outcomes following primary hypospadias repair may be recommended for secondary surgery.

Timeline

  • Before hypospadias repair: A patient is diagnosed with hypospadias, a congenital condition where the opening of the urethra is located on the underside of the penis. The patient and their family may undergo counseling and preparation for surgery.

  • During hypospadias repair: The patient undergoes surgery to correct the position of the urethral opening. The type of repair (distal, proximal, perineal) depends on the severity of the condition. The surgery is typically performed by a pediatric urologist at a hospital.

  • After hypospadias repair: The patient may experience a recovery period with postoperative care, including follow-up appointments with the surgeon. In the years following the initial surgery, the patient may require secondary surgeries for complications or to improve the cosmetic and functional outcomes of the initial repair. The rates of secondary surgeries vary depending on the type of initial repair and patient factors such as insurance status.

What to Ask Your Doctor

  1. What is the likelihood of needing a secondary surgery after the initial hypospadias repair?
  2. What specific factors may increase the risk of needing a secondary surgery?
  3. How long should I expect the recovery process to be after the initial surgery?
  4. What are the potential complications or risks associated with hypospadias repair surgery?
  5. Are there any long-term effects or considerations I should be aware of after the surgery?
  6. How experienced is the surgeon who will be performing the hypospadias repair?
  7. What is the success rate of hypospadias repair surgeries performed by the surgeon or medical team?
  8. Will I need to follow up with the doctor regularly after the surgery, and if so, how often?
  9. Are there any lifestyle or dietary changes I should make before or after the surgery to optimize the outcome?
  10. Are there any alternative treatment options or approaches for hypospadias repair that I should consider?

Reference

Authors: Nguyen S, Durbin-Johnson B, Kurzrock EA. Journal: J Urol. 2021 Jun;205(6):1778-1784. doi: 10.1097/JU.0000000000001569. Epub 2021 Feb 2. PMID: 33525924