Prevalence and surgical management of pubic hypertrophy in hypospadias patients: results from a high-volume surgeon
Int. braz. j. urol
;
45(6): 1238-1248, Nov.-Dec. 2019. tab, graf
Article
in English
| LILACS
| ID: biblio-1056340
ABSTRACT
ABSTRACT 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 andmethods:
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.
Full text:
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Index:
LILACS (Americas)
Main subject:
Lipectomy
/
Hypospadias
Type of study:
Etiology study
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Limits:
Adolescent
/
Adult
/
Humans
Country/Region as subject:
Europa
Language:
English
Journal:
Int. braz. j. urol
Journal subject:
Urology
Year:
2019
Type:
Article
Affiliation country:
Italy
Institution/Affiliation country:
BelMedic General Hospital/RS
/
University of Tor Vergata/IT
/
Vita-Salute San Raffaele University/IT
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