ESPE2022 Poster Category 1 Sex Differentiation, Gonads and Gynaecology, and Sex Endocrinology (56 abstracts)
Predictors of surgical outcomes in boys with hypospadias
Kathryn Scougall 1 , Jillian Bryce 1 , Federico Baronio 2 , Rachel L Boal 3 , Roberto Castera 4 , Sebastián Castro 4 , Tim Cheetham 3 , Eduardo Correa Costa 5 , Feyza Darendeliler 6 , Justin Davies 7 , Mirjam Dirlewanger 8 , Gabriella Gazdagh 7 , Evgenia Globa 9 , Gil Guerra-Junior 10 , Tulay Guran 11 , Gloria Herrmann 12 , Paul-Martin Holterhus 13 , Ahsen Karagözlü Akgül 14 , Renata Markosyan 15 , Anna Nordenstrom 16 , Kenneth McElreavey 17 , Marcio Lopes Miranda 10 , Sukran Poyrazoglu 6 , Gianni Russo 18 , Valerie Schwitzgebel 8 , Michael Steigert 19 , S. Faisal Ahmed 1 & Angela K Lucas-Herald 1
1Developmental Endocrinology Research Group, School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom; 2Department Hospital of Woman and Child, Pediatric Unit, Center for Rare Endocrine Conditions (Endo-ERN), IRCCS, Bologna, Italy; 3Great North Children's Hospital, Royal Victoria Hospital, Newcastle, United Kingdom; 4Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina; 5Hospital de Clínicas, Porto Alegre, Brazil; 6Istanbul University, Istanbul Faculty of Medicine, Pediatric Endocrinology Unit, Istanbul, Turkey; 7Southampton Children's Hospital, University Hospital Southampton, Southampton, United Kingdom; 8University Hospital of Geneva (HUG), Geneva, Switzerland; 9Ukrainian Research Center of Endocrine Surgery, Endocrine Organs and Tissue Transplantation, MoH of Ukraine, Kiev, Ukraine; 10Interdisciplinary Group for the Study of Sex Determination and Differentiation – GIEDDS and Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas, São Paulo, Brazil; 11Marmara University, Department of Pediatric Endocrinology and Diabetes, Istanbul, Turkey; 12Department of Pediatrics and Adolescent Medicine, University Medical Centre, Ulm, Germany; 13Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University Hospital of Schleswig-Holstein Campus Kiel/Christian-Albrechts-University of Kiel and, Kiel, Kiel, Germany; 14Marmara University Faculty of Medicine, Department of Pediatric Surgery and Division of Pediatric Urology, Istanbul, Turkey; 15Endocrinology, Yerevan State Medical University Endocrinology Clinic, Yerevan, Armenia; 16Pediatric Endocrinology and inborn errors of metabolism, Karolinska University Hospital, Stockholm, Sweden; 17. Human Developmental Genetics, Institut Pasteur, Paris, France; 18San Raffaele Scientific Institute, Milan, Italy; 19Graubunden Cantonal Hospital, Loestrasse 170, Chur, Switzerland
Introduction: Complications are frequently reported post hypospadias repair and there is a need to understand the factors that influence their occurrence.
Aim: The aim of this study was to identify the occurrence of complications in boys with hypospadias that are in the I-DSD Registry.
Methods: Data from boys born with hypospadias between 2010-2020 were obtained from the I-DSD registry. Complications were defined by abnormal function or cosmetic appearance of the penis, requiring surgical reintervention.
Results: Of the 469 eligible boys in the I-DSD Registry, data were available on 167 (36%) from 20 centres with an additional 27 patients included from one centre. The median age at the time of the study was 7.5 (3, 12) years. Of this total, 153 (92%) had hypospadias repair and of these 125 (82%) had proximal hypospadias. The overall complication rate was 56%. The most commonly reported complications were fistulae (n=28, 23%) and meatal shape or position (n=23, 18%) and the median age at time of hypospadias repair was 2 (0.8, 7) years. Genetic testing was undertaken in 118 (77%) of those undergoing repair, with variants reported in 50 (42%) of this group. Endocrine biochemistry was undertaken in 142 (94%) of those undergoing repair, with biochemical abnormalities reported in 80 (56%) of this group. Of those with proximal hypospadias, 86 (69%) had a clinical diagnosis of non-specific XY DSD; 15 (12%) had partial androgen insensitivity syndrome; 16 (13%) had disorders of androgen synthesis; 8 (6%) had partial gonadal dysgenesis. In these 4 groups of patients, complications were encountered in 48 (56%), 10 (67%), 10 (63%) and 7 (88%), respectively.
Conclusion: Complications post hypospadias repair are common in those with DSD. Complication rate may be affected by underlying diagnosis and affected patients should be counselled as such prior to surgery.
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