The diversity of hypospadias management in North America: a survey of pediatric urologists.
Hypospadias
Pediatric urology
Perioperative management
Survey
Urethroplasty
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
05
04
2023
accepted:
08
08
2023
medline:
23
10
2023
pubmed:
14
9
2023
entrez:
14
9
2023
Statut:
ppublish
Résumé
To determine trends in hypospadias management, including surgical techniques and perioperative care, by pediatric urologists in North America. An anonymous online survey was devised to assess approaches to hypospadias repair and management, including anesthetic considerations, catheter placement, choice of dressing, and postoperative antibiotic treatment. The survey was sent to all practicing members of the Societies for Pediatric Urology. The survey was completed by 133 (34.5%) respondents. Hypospadias repair was overwhelmingly recommended between ages 6-12 months (89.5%). A local or regional anesthetic block (caudal, penile, pudendal, spinal) is performed nearly universally (96.2%). The majority of surgeons perform distal repairs outpatient (70.7%), while fewer perform outpatient staged repairs (47.4%) or redo surgery (33.8%). Nearly all respondents preferred either VicrylTM/DexonTM (50.4%) or MaxonTM/PDSTM (48.1%) for urethroplasty. All but one respondent leaves a stent for midshaft to proximal repairs whereas stenting for glanular repairs was split with 53.4% leaving a stent. Most surgeons (60.9-70.9%) prescribe postoperative antibiotics regardless of severity and the majority (72.9%) prescribe narcotics for analgesia. Approaches to hypospadias repair are extremely varied such that there is a lack of consensus among pediatric urologists regarding most aspects of hypospadias management. Investigations comparing hypospadias practice patterns are necessary to develop a standard of care for this complex pediatric urologic entity.
Identifiants
pubmed: 37707567
doi: 10.1007/s00345-023-04568-9
pii: 10.1007/s00345-023-04568-9
doi:
Substances chimiques
Anti-Bacterial Agents
0
Anesthetics
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2775-2781Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Mellon RD, Simone AF, Rappaport BA (2007) Use of anesthetic agents in neonates and young children. Anesth Analg. https://doi.org/10.1213/01.ane.0000255729.96438.b0
doi: 10.1213/01.ane.0000255729.96438.b0
pubmed: 17312200
Derderian CA, Szmuk P, Derderian CK (2017) Behind the black box: The evidence for the U.S. food and drug administration warning about the risk of general anesthesia in children younger than 3 years. Plast Reconstr Surg. https://doi.org/10.1097/PRS.0000000000003691
doi: 10.1097/PRS.0000000000003691
pubmed: 28953732
Graham MR (2017) Clinical update regarding general anesthesia-Associated neurotoxicity in infants and children. Curr Opin Anaesthesiol. https://doi.org/10.1097/ACO.0000000000000520
doi: 10.1097/ACO.0000000000000520
pubmed: 28915132
Cook A, Khoury AE, Neville C, Bagli DJ, Farhat WA, Pippi Salle JL (2005) A multicenter evaluation of technical preferences for primary hypospadias repair. J Urol. https://doi.org/10.1097/01.ju.0000180643.01803.43
doi: 10.1097/01.ju.0000180643.01803.43
pubmed: 16280842
Springer A, Krois W, Horcher E (2011) Trends in hypospadias surgery: results of a worldwide survey. Eur Urol. https://doi.org/10.1016/j.eururo.2011.08.031
doi: 10.1016/j.eururo.2011.08.031
pubmed: 21871708
Alsowayan OS (2018) Management of hypospadias in Saudi Arabia: a national survey. Urol Ann. https://doi.org/10.4103/UA.UA_88_18
doi: 10.4103/UA.UA_88_18
pubmed: 30386092
pmcid: 6194794
Kim JK, Chua ME, Ming JM et al (2018) Practice variation on use of antibiotics: an international survey among pediatric urologists. J Pediatr Urol. https://doi.org/10.1016/j.jpurol.2018.04.018
doi: 10.1016/j.jpurol.2018.04.018
pubmed: 30606637
McLorie G, Joyner B, Herz D et al (2001) A prospective randomized clinical trial to evaluate methods of postoperative care of hypospadias. J Urol. https://doi.org/10.1016/s0022-5347(05)66388-4
doi: 10.1016/s0022-5347(05)66388-4
pubmed: 11586254
Horton JD, Munawar S, Corrigan C, White D, Cina RA (2019) Inconsistent and excessive opioid prescribing after common pediatric surgical operations. J Pediatr Surg. https://doi.org/10.1016/j.jpedsurg.2018.07.002
doi: 10.1016/j.jpedsurg.2018.07.002
pubmed: 30879745
van Cleve WC, Grigg EB (2017) Variability in opioid prescribing for children undergoing ambulatory surgery in the United States. J Clin Anesth. https://doi.org/10.1016/j.jclinane.2017.05.014
doi: 10.1016/j.jclinane.2017.05.014
pubmed: 28802595
Poonai N, Datoo N, Ali S et al (2017) Oral morphine versus ibuprofen administered at home for postoperative orthopedic pain in children: a randomized controlled trial. CMAJ. https://doi.org/10.1503/cmaj.170017
doi: 10.1503/cmaj.170017
pubmed: 29018084
pmcid: 5636628
Kelly LE, Sommer DD, Ramakrishna J et al (2015) Morphine or ibuprofen for post-tonsillectomy analgesia: a randomized trial. Pediatrics. https://doi.org/10.1542/peds.2014-1906
doi: 10.1542/peds.2014-1906
pubmed: 26362648
pmcid: 4567806
Lee Z, Schulte M, Defoor WR et al (2017) A non-narcotic pathway for the management of postoperative pain following pediatric robotic pyeloplasty. J Endourol. https://doi.org/10.1089/end.2016.0846
doi: 10.1089/end.2016.0846
pubmed: 29048228
pmcid: 5567874
Schröder A, Campbell FA, Farhat WA et al (2018) Postoperative pain and analgesia administration in children after urological outpatient procedures. J Pediatr Urol. https://doi.org/10.1016/j.jpurol.2017.11.014
doi: 10.1016/j.jpurol.2017.11.014
pubmed: 30770303
Glaser AP, Rosoklija I, Johnson EK, Yerkes EB (2017) Prophylactic antibiotic use in pediatric patients undergoing urinary tract catheterization: a survey of members of the Society for Pediatric Urology. BMC Urol. https://doi.org/10.1186/s12894-017-0268-5
doi: 10.1186/s12894-017-0268-5
pubmed: 28874194
pmcid: 5586033
Wolf JS, Bennett CJ, Dmochowski RR, Hollenbeck BK, Pearle MS, Schaeffer AJ (2008) Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol. https://doi.org/10.1016/j.juro.2008.01.068
doi: 10.1016/j.juro.2008.01.068
pubmed: 19091348
Kanaroglou N, Wehbi E, Alotay A et al (2013) Is there a role for prophylactic antibiotics after stented hypospadias repair? J Urol. https://doi.org/10.1016/j.juro.2013.02.015
doi: 10.1016/j.juro.2013.02.015
pubmed: 23416639
Zeiai S, Nordenskjöld A, Fossum M (2016) Advantages of reduced prophylaxis after tubularized incised plate repair of hypospadias. J Urol. https://doi.org/10.1016/j.juro.2016.04.083
doi: 10.1016/j.juro.2016.04.083
pubmed: 27157368
Roth EB, Kryger J, Durkee CT, Lingongo MA, Swedler RM, Groth TW (2018) Antibiotic prophylaxis with trimethoprim-sulfamethoxazole versus no treatment after mid-to-distal hypospadias repair: a prospective, randomized study. Adv Urol. https://doi.org/10.1155/2018/7031906
doi: 10.1155/2018/7031906
pubmed: 29780414
pmcid: 5892261
Canon S, Marquette MK, Crane A, Patel A, Zamilpa I, Bai S (2018) Prophylactic antibiotics after stented, distal hypospadias repair: randomized pilot study. Glob Pediatr Health. https://doi.org/10.1177/2333794X18770074
doi: 10.1177/2333794X18770074
pubmed: 29761139
pmcid: 5946338
Kass E, Kogan SJ, Manley C et al (1996) Timing of elective surgery on the genitalia of male children with particular reference to the risks, benefits, and psychological effects of surgery and anesthesia. Pediatrics. https://doi.org/10.1542/peds.97.4.590
doi: 10.1542/peds.97.4.590
Manzoni G, Bracka A, Palminteri E, Marrocco G (2004) Hypospadias surgery: When, what and by whom? BJU Int. https://doi.org/10.1046/j.1464-410x.2004.05128.x
doi: 10.1046/j.1464-410x.2004.05128.x
pubmed: 15613162
Dodson JL, Baird AD, Baker LA, Docimo SG, Mathews RI (2007) Outcomes of delayed hypospadias repair: implications for decision making. J Urol. https://doi.org/10.1016/j.juro.2007.03.055
doi: 10.1016/j.juro.2007.03.055
pubmed: 17574620
Marrocco G, Vallasciani S, Fiocca G, Calisti A (2004) Hypospadias surgery: a 10-year review. Pediatr Surg Int. https://doi.org/10.1007/s00383-004-1147-1
doi: 10.1007/s00383-004-1147-1
pubmed: 15083330
Bush NC, Holzer M, Zhang S, Snodgrass W (2013) Age does not impact risk for urethroplasty complications after tubularized incised plate repair of hypospadias in prepubertal boys. J Pediatr Urol. https://doi.org/10.1016/j.jpurol.2012.03.014
doi: 10.1016/j.jpurol.2012.03.014
pubmed: 24439629
pmcid: 3770743
Snodgrass W, Villanueva C, Bush N (2014) Primary and reoperative hypospadias repair in adults—Are results different than in children? J Urol. https://doi.org/10.1016/j.juro.2014.07.012
doi: 10.1016/j.juro.2014.07.012
pubmed: 25526998
Carmack A, Notini L, Earp BD (2016) Should surgery for hypospadias be performed before an age of consent? J Sex Res. https://doi.org/10.1080/00224499.2015.1066745
doi: 10.1080/00224499.2015.1066745
pubmed: 26479354
Chalmers DJ, Siparsky GL, Wiedel CA, Wilcox DT (2015) Distal hypospadias repair in infants without a postoperative stent. Pediatr Surg Int. https://doi.org/10.1007/s00383-014-3647-y
doi: 10.1007/s00383-014-3647-y
pubmed: 25475503
Hsieh MH, Wildenfels P, Gonzales ET (2011) Surgical antibiotic practices among pediatric urologists in the United States. J Pediatr Urol. https://doi.org/10.1016/j.jpurol.2010.05.001
doi: 10.1016/j.jpurol.2010.05.001
pubmed: 20833109
Chua M, Welsh C, Amir B et al (2018) Non-stented versus stented urethroplasty for distal hypospadias repair: a systematic review and meta-analysis. J Pediatr Urol. https://doi.org/10.1016/j.jpurol.2017.11.023
doi: 10.1016/j.jpurol.2017.11.023
pubmed: 30606637
Radmayr C, Bogaert G, Burgu B, Castagnetti MS, Dogan HS, O’Kelly F, Quaedackers J, Rawashded YFH, Silay MS (2023) EAU guidelines on paedeatric urology. Section 3.6 Hypospadias. https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Paediatric-Urology-2023.pdf