Mp50-08 Practice Patterns in Proximal Hypospadias Care Among Pediatric Urologists

You have accessJournal of UrologyPediatrics III (MP50)1 May 2024MP50-08 PRACTICE PATTERNS IN PROXIMAL HYPOSPADIAS CARE AMONG PEDIATRIC UROLOGISTS James Rague, Ilina Rosoklija, David Chu, Earl Cheng, and Emilie Johnson James RagueJames Rague , Ilina RosoklijaIlina Rosoklija , David ChuDavid Chu , Earl ChengEarl Cheng , and Emilie JohnsonEmilie Johnson View All Author Informationhttps://doi.org/10.1097/01.JU.0001008684.57262.97.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: About 25% of patients with hypospadias have a proximal form, often associated with an underlying genetic cause or difference of sex development (DSD). Surgical complication rates are high, surgical practice patterns are variable, and consensus recommendations to guide medical and surgical management are not yet available. One presumed barrier to consensus is understanding variability in management for this condition. We aimed to assess medical and surgical practice patterns of pediatric urologists regarding care of proximal hypospadias. METHODS: An anonymous, web-based survey about proximal hypospadias medical and surgical management practices was sent to members of the Societies for Pediatric Urology. Respondent demographics were obtained. Median estimated patients operated on per year was determined. Comparisons between those ≤50th percentile for hypospadias surgical volume and >50th percentile were made using chi square test. RESULTS: 128 completed surveys were returned (128/311 (41%) opened emails). Respondents were predominantly male (71%), and practice in an urban (85%), academic (72%) setting. The median (IQR) estimated number of patients cared for per year was 6.5 (5.0, 10.0). Half (50%) never receive referrals from other pediatric urologists for surgical care. Most never refer patients to other surgeons within (55%) or outside (72%) of their practice. Frequent independent ordering of a karyotype was reported, with less frequent ordering of hormonal and advanced genetic testing (Table 1). Performing systematic, post-operative data collection was reported infrequently (38%). Those >50th percentile in volume compared to those ≤50th percentile reported receiving more referrals from other urologists for surgical care (any referrals received, 66% vs 36%, p=0.002) and more commonly perform surgery without a co-attending surgeon (63% vs 32%, p=0.005). There were no difference between groups regarding lab testing, medical specialty referrals, or surgical management. CONCLUSIONS: Proximal hypospadias surgery is uncommonly performed by most pediatric urologists and patterns of medical evaluation are variable. Few differences in practice were seen based on volume. Standardized care recommendations with consistent assessment of post-operative outcomes may represent an opportunity for improved care in proximal hypospadias. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e833 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information James Rague More articles by this author Ilina Rosoklija More articles by this author David Chu More articles by this author Earl Cheng More articles by this author Emilie Johnson More articles by this author Expand All Advertisement PDF downloadLoading ...