Prevalence, repairs and complications of hypospadias: an Australian population-based study

Abstract

Objective: To investigate hypospadias prevalence and trends, rate of surgical repairs and post-repair complications in an Australian population. Methods: Hypospadias cases were identified from all live born infants in New South Wales, Australia, 2001-2010 using routinely collected birth and hospital data. Prevalence, trends, surgical procedures or repairs, hospital admissions and complications following surgery were evaluated. Risk factors for re-operation and complications were assessed using multivariate logistic regression. Results: There were 3,186 boys with hypospadias in 2001-2010. Overall prevalence was 35.1 per 10,000 livebirths and remained constant during the study period. Proportions of anterior, middle, proximal and unspecified hypospadias were 41.3%, 26.2%, 5.8% and 26.6%, respectively. Surgical procedures were performed in 1,945 (61%) boys, with 1,718 primary repairs. The overall post-surgery complication rate involving fistulas or strictures was 13%, but higher (33%) for proximal cases. Complications occurred after one year post-repair in 52.3% of cases and up to five years. Boys with proximal or middle hypospadias were at increased risk of re-operation or complications, but age at primary repair did not affect the outcome. Conclusions: One in 285 infants were affected with hypospadias, 60% required surgical repair or correction and one in eight experienced complications. The frequency of late complications would suggest that clinical review should be maintained for more than one year post-repair.