Analysis of risk factors for glans dehiscence after tubularized incised plate hypospadias repair

Warren Snodgrass, Nicholas Cost, Paul A. Nakonezny, Nicol Bush

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44 Scopus citations

Abstract

Purpose: We determined the incidence of glans dehiscence and the associated risk factors after tubularized incised plate hypospadias repair. Materials and Methods: All data for patients undergoing tubularized incised plate hypospadias repair, surgical details and postoperative outcomes were prospectively maintained in databases. Data were analyzed with simple and multiple logistic regression to determine if patient age, preoperative testosterone use, meatal location (distal, mid shaft or proximal), glansplasty sutures (chromic catgut vs polyglactin) or primary vs revision tubularized incised plate procedure was associated with an increased risk of glans dehiscence. Results: Glans dehiscence occurred in 32 of 641 patients (5%). Age at surgery, preoperative testosterone use and glansplasty suture did not impact the risk of glans dehiscence. Glans dehiscence occurred in 20 of 520 distal (4%), 1 of 47 mid shaft (2%) and 11 of 74 proximal (15%) tubularized incised plate repairs, with the odds of glans dehiscence being 3.6 times higher in patients with proximal vs distal meatal location. Patients undergoing reoperative (9 of 64, 14%) vs primary tubularized incised plate (23 of 577, 4%) had a 4.7-fold increased risk of glans dehiscence. Conclusions: Proximal meatal location and revision surgery, most commonly for prior glans dehiscence, increase the odds of glans dehiscence by 3.6 and 4.7-fold, respectively, suggesting anatomical and/or host factors (wound healing) are more important than age, type of suture or preoperative testosterone use in the development of this postoperative complication.

Original languageEnglish (US)
Pages (from-to)1845-1851
Number of pages7
JournalJournal of Urology
Volume185
Issue number5
DOIs
Publication statusPublished - May 2011

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Keywords

  • hypospadias
  • male
  • penis
  • postoperative complications
  • surgical wound dehiscence
  • urologic surgical procedures

ASJC Scopus subject areas

  • Urology

Cite this

Analysis of risk factors for glans dehiscence after tubularized incised plate hypospadias repair. / Snodgrass, Warren; Cost, Nicholas; Nakonezny, Paul A.; Bush, Nicol.

In: Journal of Urology, Vol. 185, No. 5, 05.2011, p. 1845-1851.

Research output: Contribution to journalArticle