Clinical characteristics, socioeconomic factors and COVID-19 were associated with delayed surgery in children with hypospadias: a retrospective study of 4439 cases in a single center
Abstract Background Hypospadias is one of the most common congenital diseases of the genitourinary system in children. The European Association of Urology (EAU) Guidelines recommend that children undergoing hypospadias surgery should be between 6 and 18 months. In China, where many children have hyp...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40001-022-00744-6 |
| _version_ | 1817968886670163968 |
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| author | Gaochen Bai Feng Liang Tianxin Zhao Fuming Deng Kai Fu Xiong Chen Zhongmin Li Liyu Zhang Wei Jia Wen Fu Guochang Liu |
| author_facet | Gaochen Bai Feng Liang Tianxin Zhao Fuming Deng Kai Fu Xiong Chen Zhongmin Li Liyu Zhang Wei Jia Wen Fu Guochang Liu |
| author_sort | Gaochen Bai |
| collection | DOAJ |
| description | Abstract Background Hypospadias is one of the most common congenital diseases of the genitourinary system in children. The European Association of Urology (EAU) Guidelines recommend that children undergoing hypospadias surgery should be between 6 and 18 months. In China, where many children have hypospadias, it remains unknown whether clinical characteristics, socioeconomic factors and COVID-19 were associated with delayed surgery in children with hypospadias. Methods We retrospectively analyzed children with hypospadias who underwent primary surgery at the Department of Pediatric Urology in Guangzhou Women and Children’s Medical Center between January 2010 and October 2021. Patients who had two-stage surgery or a second round of surgery due to complications were excluded to eliminate data duplication. The clinical characteristics and demographic information were collected. We defined delayed surgery as primary surgery performed after 18 months following the EAU Guidelines. Results A total of 4439 children diagnosed with hypospadias were included in the study. The median age (29.1 ± 16.7 months) of surgery for hypospadias in our study was much higher than the recommended age reported in the EAU guidelines, and 76.6% of the children underwent surgery after the age of 18 months. Children without comorbidities including cryptorchidism (odds ratio [OR] = 1.562; 95% confidence interval [CI] 1.199–2.034; p = 0.001), prostatic cyst (OR = 2.613; 95% CI 1.579–4.324; p < 0.001), penile hypoplasia (OR = 1.778; 95% CI 1.225–2.580; p = 0.002), inguinal hernia (OR = 2.070; 95% CI 1.394–3.075; p < 0.001), and penoscrotal transposition (OR = 4.125; 95% CI 1.250–13.619; p = 0.020) were more likely to receive delayed surgery. Living in a low economic area (OR = 1.731; 95% CI 1.068–2.806; p = 0.026) or not close to a main medical center (OR = 1.580; 95% CI 1.370–1.824; p < 0.001) was highly associated with delayed surgery. The proportion of children undergoing delayed surgery and the median age of surgery during the COVID-19 pandemic were significantly higher than those before the COVID-19 pandemic (p = 0.004 and < 0.001, respectively). Conclusions Most children with hypospadias received delayed surgery (surgical age > 18 months). Comorbidities, living in a low economic area, too far from a main medical center and the COVID-19 pandemic were highly associated with delayed surgery. It is vital to improve the public awareness of hypospadias and strengthen the re-education of primary community doctors to reduce delayed surgery. |
| first_indexed | 2024-04-13T20:14:25Z |
| format | Article |
| id | doaj.art-85408ca6f1d14006ba4554a8d82138d0 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-04-13T20:14:25Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-85408ca6f1d14006ba4554a8d82138d02022-12-22T02:31:45ZengBMCEuropean Journal of Medical Research2047-783X2022-07-012711810.1186/s40001-022-00744-6Clinical characteristics, socioeconomic factors and COVID-19 were associated with delayed surgery in children with hypospadias: a retrospective study of 4439 cases in a single centerGaochen Bai0Feng Liang1Tianxin Zhao2Fuming Deng3Kai Fu4Xiong Chen5Zhongmin Li6Liyu Zhang7Wei Jia8Wen Fu9Guochang Liu10Department of Pediatric Urology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityClinical Data Center, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Pediatric Urology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Pediatric Urology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Pediatric Urology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Pediatric Urology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Pediatric Urology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Pediatric Urology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Pediatric Urology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Pediatric Urology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Pediatric Urology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityAbstract Background Hypospadias is one of the most common congenital diseases of the genitourinary system in children. The European Association of Urology (EAU) Guidelines recommend that children undergoing hypospadias surgery should be between 6 and 18 months. In China, where many children have hypospadias, it remains unknown whether clinical characteristics, socioeconomic factors and COVID-19 were associated with delayed surgery in children with hypospadias. Methods We retrospectively analyzed children with hypospadias who underwent primary surgery at the Department of Pediatric Urology in Guangzhou Women and Children’s Medical Center between January 2010 and October 2021. Patients who had two-stage surgery or a second round of surgery due to complications were excluded to eliminate data duplication. The clinical characteristics and demographic information were collected. We defined delayed surgery as primary surgery performed after 18 months following the EAU Guidelines. Results A total of 4439 children diagnosed with hypospadias were included in the study. The median age (29.1 ± 16.7 months) of surgery for hypospadias in our study was much higher than the recommended age reported in the EAU guidelines, and 76.6% of the children underwent surgery after the age of 18 months. Children without comorbidities including cryptorchidism (odds ratio [OR] = 1.562; 95% confidence interval [CI] 1.199–2.034; p = 0.001), prostatic cyst (OR = 2.613; 95% CI 1.579–4.324; p < 0.001), penile hypoplasia (OR = 1.778; 95% CI 1.225–2.580; p = 0.002), inguinal hernia (OR = 2.070; 95% CI 1.394–3.075; p < 0.001), and penoscrotal transposition (OR = 4.125; 95% CI 1.250–13.619; p = 0.020) were more likely to receive delayed surgery. Living in a low economic area (OR = 1.731; 95% CI 1.068–2.806; p = 0.026) or not close to a main medical center (OR = 1.580; 95% CI 1.370–1.824; p < 0.001) was highly associated with delayed surgery. The proportion of children undergoing delayed surgery and the median age of surgery during the COVID-19 pandemic were significantly higher than those before the COVID-19 pandemic (p = 0.004 and < 0.001, respectively). Conclusions Most children with hypospadias received delayed surgery (surgical age > 18 months). Comorbidities, living in a low economic area, too far from a main medical center and the COVID-19 pandemic were highly associated with delayed surgery. It is vital to improve the public awareness of hypospadias and strengthen the re-education of primary community doctors to reduce delayed surgery.https://doi.org/10.1186/s40001-022-00744-6HypospadiasDelayed surgeryClinical characteristicsSocioeconomic factorsCOVID-19 |
| spellingShingle | Gaochen Bai Feng Liang Tianxin Zhao Fuming Deng Kai Fu Xiong Chen Zhongmin Li Liyu Zhang Wei Jia Wen Fu Guochang Liu Clinical characteristics, socioeconomic factors and COVID-19 were associated with delayed surgery in children with hypospadias: a retrospective study of 4439 cases in a single center European Journal of Medical Research Hypospadias Delayed surgery Clinical characteristics Socioeconomic factors COVID-19 |
| title | Clinical characteristics, socioeconomic factors and COVID-19 were associated with delayed surgery in children with hypospadias: a retrospective study of 4439 cases in a single center |
| title_full | Clinical characteristics, socioeconomic factors and COVID-19 were associated with delayed surgery in children with hypospadias: a retrospective study of 4439 cases in a single center |
| title_fullStr | Clinical characteristics, socioeconomic factors and COVID-19 were associated with delayed surgery in children with hypospadias: a retrospective study of 4439 cases in a single center |
| title_full_unstemmed | Clinical characteristics, socioeconomic factors and COVID-19 were associated with delayed surgery in children with hypospadias: a retrospective study of 4439 cases in a single center |
| title_short | Clinical characteristics, socioeconomic factors and COVID-19 were associated with delayed surgery in children with hypospadias: a retrospective study of 4439 cases in a single center |
| title_sort | clinical characteristics socioeconomic factors and covid 19 were associated with delayed surgery in children with hypospadias a retrospective study of 4439 cases in a single center |
| topic | Hypospadias Delayed surgery Clinical characteristics Socioeconomic factors COVID-19 |
| url | https://doi.org/10.1186/s40001-022-00744-6 |
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