Prevalence, assessment and surgical correction of penile curvature in hypospadias patients treated at one European Referral Center: description of the technique and surgical outcomes

World J Urol. 2020 Aug;38(8):2041-2048. doi: 10.1007/s00345-019-02961-x. Epub 2019 Oct 25.

Abstract

Purpose: Penile curvature (PC) is a common component of hypospadias, but its presence is inconstantly assessed. We aim to report prevalence of PC in hypospadias patients, as well as to report our method to assess and correct PC, with the associated postoperative outcomes.

Methods: We scrutinized 303 pediatric hypospadias patients operated (2013-2018) at our referral center. PC was routinely assessed and eventually corrected with dorsal plications (DP) as one-stage procedure, or ventral tunica attenuations ± DP as two-stage repair. PC severity and surgical treatment of PC were compared between primary and failed hypospadias. Finally, PC severity, failed repair and PC treatment were tested as predictors of perioperative complications.

Results: PC (> 10°) was identified in 274/303 (90.4%) patients, 86.1% with distal, 91.8% with midshaft, and 100% with proximal hypospadias, respectively. PC was found in 51/64 (79.7%) of failed hypospadias. One-stage and two-stage procedures were adopted in 211/274 (77%) and 63/274 (23%) children, respectively. PC severity (p = 0.1) and PC treatment (p = 0.4) did not differ between primary and failed hypospadias. PC severity (all p > 0.2), failed repair (p = 0.8), and PC treatment (all p > 0.09) were not predictors of perioperative complications. 95.6% of patients achieved a straight penis.

Conclusion: Less than 1/10 patients did not require PC correction. High rate of residual PC in failed hypospadias and similar severity between failed and primary suggest that PC was usually under-corrected. It is possible to correct PC completely and the resulting complication would not be associated with PC severity, failed repair or treatment adopted.

Keywords: Chordee; Hypospadias; Pediatric urology; Penile curvature; Referral Center.

MeSH terms

  • Child
  • Child, Preschool
  • Humans
  • Hypospadias / complications
  • Hypospadias / surgery*
  • Infant
  • Male
  • Penile Induration / diagnosis
  • Penile Induration / epidemiology*
  • Penile Induration / etiology
  • Penile Induration / surgery*
  • Prevalence
  • Referral and Consultation
  • Retrospective Studies
  • Serbia
  • Treatment Outcome
  • Urologic Surgical Procedures, Male / methods