Prevalence and surgical management of pubic hypertrophy in hypospadias patients: results from a high-volume surgeon



Título del documento: Prevalence and surgical management of pubic hypertrophy in hypospadias patients: results from a high-volume surgeon
Revista: International braz j urol
Base de datos: PERIÓDICA
Número de sistema: 000434671
ISSN: 1677-5538
Autores: 1
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3
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Instituciones: 1BelMedic General Hospital, Center for Genito-Urinary Reconstructive Surgery, Belgrado. Serbia
2Universita Vita-Salute San Raffaele, Ospedale San Raffaele, Milán, Lombardia. Italia
3Universita degli Studi di Roma "Tor Vergata", Dipartimento di Medicina e Chirurgia Sperimentale, Roma, Lazio. Italia
Año:
Periodo: Nov-Dic
Volumen: 45
Número: 6
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Aplicado, descriptivo
Resumen en inglés Introduction: Pubic hypertrophy, defined as an abnormal and abundant round mass of fatty tissue located over the pubic symphysis, is frequently underestimated in patients with hypospadias. We examined the prevalence of this condition, as well as the outcomes associated with its surgical treatment. Material and methods: Within 266 hypospadias patients treated at our clinic, we assessed the prevalence of pubic hypertrophy, and we schematically described the surgical steps of pubic lipectomy. Multivariable logistic regression (MLR) tested for predictors of pubic hypertrophy. Finally, separate MLRs tested for predictors of fistula and any complications after pubic lipectomy. Results: Of 266 hypospadias patients, 100 (37.6%) presented pubic hypertrophy and underwent pubic lipectomy. Patients with pubic hypertrophy more frequently had proximal hypospadias (44 vs. 7.8%), disorders of sex development (DSD) (10 vs. 0.6%), cryptorchidism (12 vs. 2.4%), and moderate (30°-60°) or severe (>60°) penile curvature (33 vs. 4.2%). In MLR, the location of urethral meatus (proximal, Odds ratio [OR]: 10.1, p<0.001) was the only significant predictor of pubic hypertrophy. Finally, pubic lipectomy was not associated with increased risk of fistula (OR: 1.12, p=0.7) or any complications (OR: 1.37, 95% CI: 0.64-2.88, p=0.4) after multivariable adjustment. Conclusions: One out of three hypospadias patients, referred to our center, presented pubic hypertrophy and received pubic lipectomy. This rate was higher in patients with proximal hypospadias suggesting a correlation between pubic hypertrophy and severity of hypospadias. Noteworthy, pubic lipectomy was not associated with increased risk of fistula or any complications
Disciplinas: Medicina
Palabras clave: Urología,
Cirugía,
Pediatría,
Hipospadias,
Hipertrofia púbica,
Lipectomía,
Cirugía reconstructiva
Keyword: Urology,
Surgery,
Pediatrics,
Pubic hypertrophy,
Hypospadias,
Lipectomy,
Reconstructive surgery
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