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Factors associated with reoperation in hypospadias surgery – A nationwide, population-based study.

Factors associated with reoperation in hypospadias surgery – A nationwide, population-based study.
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Lu YC, Huang WY, Chen YF, Chang HC, Pong YH, Shih TH, Huang KH,


Lu YC, Huang WY, Chen YF, Chang HC, Pong YH, Shih TH, Huang KH, (click to view)

Lu YC, Huang WY, Chen YF, Chang HC, Pong YH, Shih TH, Huang KH,

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Asian journal of surgery 2016 01 2640(2) 116-122 pii S1015-9584(15)00115-3
Abstract
BACKGROUND/OBJECTIVE
To analyze the preoperative factors associated with the need for secondary surgery following primary urethroplasty.

METHODS
This study utilized a subset of the National Health Insurance Research Database, which includes the data on all paid medical benefit claims from 1997 to 2007, for 1 million beneficiaries in 2005. We analyzed the claims data for all patients with hypospadias who had undergone primary urethroplasty. The characteristics of the patients, surgeons, and hospitals associated with surgical outcomes were analyzed to investigate possible associations with the need for secondary surgery.

RESULTS
Among 52,705 live male newborn babies, 218 were diagnosed with hypospadias, of whom 89 received repair surgery. A total of 75 (84.3%) male newborn babies received single hypospadias surgery, and 14 (15.7%) underwent more than two surgical procedures. Univariate analysis demonstrated that the type of hypospadias and the surgeon caseload volume were significantly associated with the need for additional hypospadias surgery (p = 0.02 and p = 0.03, respectively). In multivariate analysis, the type of hypospadias (distal vs. proximal, odds ratio, 0.25; p = 0.03) and the surgeon caseload volume (high vs. low, odds ratio, 0.04; p = 0.05) were significantly correlated with secondary operation.

CONCLUSION
The type of hypospadias and the surgeon caseload volume were significantly associated with the need for secondary hypospadias surgery. The findings of this study provide important information on the outcomes of hypospadias repair for parents and specialists.

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