Assessment of postoperative cosmetic outcomes of distal form hypospadias repair with the Hypospadias Objective Scoring Evaluation (HOSE)Assessment of postoperative cosmetic outcomes of distal form hypospadias repair with the Hypospadias Objective Scoring
Aim A standardized assessment for the optimal repair of hypospadias remains elusive. The aim of this study was to assess a postoperative cosmetic outcome of hypospadias repair using a validated questionnaire, Hypospadias Objective Scoring Evaluation (HOSE). Methods During the period between January 2016 and May 2019, 40 patients who underwent hypospadias repair were identified and they agreed to a follow-up using the HOSE. Distal hypospadias repairs underwent a cross-sectional assessment of the cosmetic outcome. Cosmetic assessment was performed by an independent physician using the HOSE scoring system. Results The native meatus was coronal in 10 (25%), subcoronal in eight (20%), and distal penile in 22 (55%) patients. Mean followup was 35.90 months (SD ±29.58) postoperatively (range 12–162 months). Complications occurred in one (2.5%) patient. Out of 40 uncomplicated repairs, 39 (97.5%) were satisfactory. A vertical slit-like meatus located at the distal glans was created in 33 (82.5%) boys, and at the proximal glans in seven (17.5%). The urinary stream was single and straight in 39 and spray in one patient. A straight erection was observed in 39 (97.5%) boys. The median HOSE score was 16 (range 12–16). One patient had a small, single coronal fistula. The technique used included tubularised incised plate urethroplasty. Conclusion The HOSE score is simple, easy, non-invasive and non-expensive tool for objective assessment of long-term outcomes of hypospadias repair.
Hutton K, Babu R. Normal anatomy of the external urethral meatus in boys: implications for hypospadias repair. Br J Urol 2007:161–3.
2
Jonuzi A, Popović N, Zvizdić Z, Milišić E, Halimić A, Kulovac B. Evaluation of the results Snodgrass procedure tubularized incised plate (TIP) in hypospadias surgery-our results for the period of 2010-2015. Med Journal 2016:188–91.
3
Gurdal M, Tekin A, Kirecci S, Sengor F. Intermediate-term functional and cosmetic results of the Snodgrass procedure in distal and midpenile hypospadias. Pediatr Surg Int 2004:197–9.
4
Diamond D. Advances in paediatric urology. Lancet 2017:1061–71.
5
Mousavi S, Arabi M. Tubularized incised plate urethroplasty: a review and meta-analysis. Int Braz J Urol 2014:588–95.
6
Snodgrass W, Macedo A, Hoebeke P, Mouriquand P. Hypospadias dilemmas: a round table. J Pediatr Urol 2011:145–57.
7
Naser S, Shapiee B, Mohd A, Mohd N. Cosmetic and functional outcomes of two-stage hypospadias repair: an objective scoring evaluation and uroflowmetry. Turk J Urol 2013:90–5.
8
Weber D. RE: introducing the HOPE (Hypospadias Objective Penile Evaluation)-score: a validation study of an objective scoring system for evaluating cosmetic appearance in hypospadias patients. J Pediatr Urol 2013:1016.
9
Weber D, Schonbucher V, Landolt M, Gobet R. The Pediatric Penile Perception Score :an instrument for patient self-assessment and surgeon evaluation after hypospadias repair. J Urol 2008:1080–4.
10
Mureau M, Slijper F, Slob A, Verhulst F, Nijman R. Satisfaction with penile appearance after hypospadias surgery: the patient and surgeon view. J Urol 1996:703–6.
11
Jonuzi A, Zvizdić Z, Popović N, Milišić E, Begić E, Kulovac B. Effect of preoperative hormonal therapy in hypospadias surgery: evaluation of the current practice at the Pediatric Surgery Clinic. Iran J Pediatr Surg 2019:27–32.
12
Liu M, Holland A, Cass D. Assessment of postoperative outcomes of hypospadias repair with validated questionnaires. J Pediatr Surg 2015:2071–4.
13
Erol A, Baskin L, Li Y, Liu W. Anatomical studies of the urethral plate: why preservation of the urethral plate is important in hypospadias repair. BJU Int 2000:728–34.
14
Holland A, Smith G, Ross F, Cass D. HOSE: an objective scoring system for evaluating the result of hypospadias surgery. BJU Int 2001:255–8.
15
Vavilov S, Smith G, Starkey M, Pockney P, Deshpande A. Parental decision regret in childhood hypospadias surgery: A systematic review. J Paediatr Child Health 2020:1514–20.
16
Genc¸ A, Taneli C, Oksel F, Balkan C, Bilgi Y. Analysis of meatal location in 300 boys. Int Urol Nephrol 2001:663–4.
17
Abbas T, Vallasciani S, Elawad A, Elifranji M, Leslie B, Elkadhi A, et al. Plate Objective Scoring Tool (POST); An objective methodology for the assessment of urethral plate in distal hypospadias. J Pediatr Urol 2020:675–82.
18
Hayashi Y, Kojima Y, Mizuno K, Kurokawa S, Nakane A, Kohri K. Achieving a natural glanular meatus for distal hypospadias with a narrow and shallow plate: tubularized incised plate versus modified Barcat repair. Int J Urol 2008:616–20.
19
Snodgrass W. Snodgrass technique for hypospadias repair. BJU Int 2005:683–93.
20
Snodgrass W, Bush N. Primary hypospadias repair techniques: a review of the evidence. Urology Ann 2016:403–8.
21
Al-Adl A, El-Karamany T, Bassiouny A. Distal extension of the midline urethral-plate incision in the Snodgrass hypospadias repair: An objective assessment of the functional and cosmetic outcomes. Arab J Urol 2014:116–26.
22
Snodgrass W. Tubularized incised plate urethroplasty for distal hypospadias. J Urol 1994:464–5.
23
Adams J, Bracka A. Reconstructive surgery for hypospadias: a systematic review of long-term patient satisfaction with cosmetic outcomes. Indian J Urol 2016:93–102.
24
Bergman J, Loane M, Vrijheid M, Pierini A, Nijman R, Addor M, et al. Epidemiology of hypospadias in Europe: a registry-based study. World J Urol 2015:2159–67.
25
Güner E, Arıkan Y. Evaluation of surgical outcomes in different hypospadias types by HOSE Score. J Urol Surg 2020:54–7.
26
Springer A. Assessment of outcome in hypospadias surgery -a review. Front Pediatr 2014:2.
27
Jiang D, Gillis K, Chakiryan N, Acevedo A, Austin J, Seideman C. Work relative value units do not account for complexity and operative time in hypospadias surgery. J Pediatr Urol 2020:459-e460.
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