There are an array of factors that contribute to variability in hypospadias repair,
with few surgical procedures demonstrating such extensive surgeon-to-surgeon and patient-to-patient
differences. The current project was the broadest network study reported to date evaluating
the procedural descriptions provided in operative notes and templates describing hypospadias
repairs. The key findings are that 1) procedural descriptions vary widely by surgeon
across categorically similar hypospadias repairs and 2) templates provided key technical
details across a broad network, aligning closely with reported common techniques by
surgeon. Of note, this is not an outcomes study, nor is it a phenotype evaluation,
as these were not the aims of this scoping project. Certainly, all of this information
is needed, and collaboration will be the key to ensure that broad data sets are captured
that contain standardized data collection of anatomic phenotype, surgical technique,
and short- and long-term clinical outcomes.
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References
- Outcomes of tubularized incised plate urethroplasty (TIPU) for hypospadias at tikur anbesa specialized and menelik II referral hospitals: one-year prospective cohort study.Urology. 2022; 168: 189-194
- Proximal hypospadias: we aren't always keeping our promises.F1000Res. 2016; 5 (Epub 2016/10/18)
- Measurement accuracy of 3-Dimensional mapping technologies versus standard goniometry for angle assessment.J Pediatr Urol. 2020; 16: 547-554
- Assessing quality of life of patients with hypospadias: a systematic review of validated patient-reported outcome instruments.J Pediatr Urol. 2017; 13: 19-27
- External validation of a low fidelity dry-lab platform to enhance loupes surgical skills techniques for hypospadias repair.J Pediatr Urol. 2022; 18: 765.e1-765.e6
Article info
Publication history
Published online: February 26, 2023
Accepted:
February 10,
2023
Received:
February 10,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Surgical process variables for the classification of hypospadiasJournal of Pediatric Urology
- PreviewI read the article published by the Western Pediatric Urology Consortium (WPUC) network on identifying variability in surgical practices and instruments used for hypospadias repair [1]. Despite the authors' efforts, I think it is not possible to use this study to understand what variables can be reliably measured for future surgical outcomes in hypospadias. There are mainly two types of variables to measure in surgical research studies: patient outcomes and surgical process. In fact, almost all “variables” in this study are patient, surgeon and procedure-related confounding variables and/or contributing factors (such as patient classification as distal TIP and proximal hypospadias, level of expertise of practicing fellow surgeons, operative templates, tissues used, suture types and catheter selection, etc.), making it difficult to draw valid conclusions.
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