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Background: Anogenital distance (AGD) in animals is a sensitive biomarker of fetal endocrine disruption and the associated testicular dysgenesis syndrome (TDS). However, AGD in human infants with cryptorchidism and hypospadias, which are potential manifestations of TDS during childhood, is not clearly described. Objective: Our aim was to compare AGD in boys with cryptorchidism or hypospadias against normative data. Methods: Boys with isolated cryptorchidism (n = 71, age 13.4 ± 5.8 months) or hypospadias (n = 81, age 11.4 ± 6.2 months) were recruited from a tertiary center for measurement of AGD and penile length; they were compared with 487 healthy full-term boys from a birth cohort by deriving age-specific standard deviation scores (SDS). Results: Boys with cryptorchidism were older (p = 0.048) compared with boys with hypospadias. Boys with hypospadias had shorter mean AGD and penile length SDS than healthy boys (both p < 0.0001). Mean AGD and penile length SDS values in boys with cryptorchidism were longer than mean values in boys with hypospadias (both p < 0.01) and shorter than mean values in healthy boys (both p < 0.0001). Mean penile length SDS decreased as the severity of hypospadias increased (ptrend = 0.078). Conclusions: In the study population, AGD and penile length were reduced in boys with hypospadias or cryptorchidism relative to normative data derived from a longitudinal birth cohort. The findings support the use of AGD as a quantitative biomarker to examine the prenatal effects of exposure to endocrine disruptors on the development of the male reproductive tract. [ABSTRACT FROM AUTHOR]

The role of the urology nurse in the care of 50 boys undergoing hypospadias surgery was prospectively evaluated using semi-structured interviews and data retrieved from hospital notes. Four nursing-related areas of interest were identified: Firstly, that nurses were instrumental in preparing the families for surgery by assessing the boys and providing information to the families. This enabled the early discharge of the children. Secondly, that nurses also dealt with any problems arising from pain or the wound as well as from the catheter or stent. Thirdly, that named nurses provided seamless care to the families enabling a development of familiarity and trust. Finally, nurses provided routine back-up and a 24-h emergency call facility for the families at home. These were valued by the parents for their reassuring and confidence giving effect as well as the quality of the advice given. Based on the results of this evaluation it was recommended to establish and introduce a care pathway for day-case hypospadias repairs and to upgrade the urology nurses' role towards advanced nursing practice. [ABSTRACT FROM AUTHOR]

Little is known about the role of maternal nutrition in the development of hypospadias, which is the most common urogenital congenital anomaly. This study investigated the relationship between maternal nutrition and the risk of hypospadias, particularly focusing on maternal food patterns. We compared 471 hypospadias cases with 490 controls in the United Kingdom. A questionnaire including information on life style, occupation, usual maternal diet and dietary supplements was administered using telephone interviews. Cases and controls were compared for individual food item intake and food patterns derived by cluster analysis. Multivariable logistic regression analysis adjusted for income, maternal age, low birthweight, smoking and folic acid supplement use was used to assess the relationship between maternal nutrition and hypospadias. Three food patterns were created with the labels 'health conscious', 'mixed' and 'non-health conscious'. 'Non-health conscious' subjects (low frequency of consumption of yoghurt, cheese, eggs, fruit and vegetables, fish, beans and pulses, olive oil and organic food) had a higher risk of hypospadias (odds ratio 1.54; 95% confidence interval 1.06, 2.26) compared with 'health conscious' subjects (high frequency of consumption of fresh fruit and vegetables, dried fruit, fresh or frozen fish, beans, pulses, soya products, olive oil and organic food), after adjustment for potential confounders. Intakes of individual foods were not strongly associated with hypospadias. We could not exclude the possibility of residual confounding, and this needs to be further investigated. We found an association between food pattern and hypospadias, with those with less health conscious food patterns having a higher risk. Further study is needed to confirm this association. [ABSTRACT FROM AUTHOR]

Summary: Aim: To find out what primary hypospadias surgery is being done in the United Kingdom and at what ages patients have surgery. Methods: On behalf of the British Associations of Paediatric Urologists, Paediatric Surgeons and Plastic, Reconstructive and Aesthetic Surgeons, paediatric surgeons/urologists, plastic surgeons and urologists were asked to record prospectively their data for 12 months, October 2006–September 2007. Results: There were 50 replies (response rate 50%, 79% of plastic surgeons and 40% of paediatric surgeons/urologists). Most patients had distal hypospadias. The total numbers of operations were 814 (paediatric surgeons/urologists), 436 (plastic surgeons) and 5 (one urologist). More than 20 operations a year were performed by 79% of paediatric surgeons/urologists and 35% of plastic surgeons. Both groups used a similar range of single-stage and two-stage operations. Patients'' ages at surgery were less than two years for 68% of paediatric surgeons/urologists and two to four years for 60% of plastic surgeons. Conclusions: In the UK most primary hypospadias surgery in children is performed by paediatric surgeons/urologists and plastic surgeons. Both groups of surgeons use a range of procedures. Many plastic surgeons are low volume operators. Most plastic surgeons operate on children two or more years old. Plastic surgeons should change their hypospadias service. All hypospadias surgeons should contribute to future prospective outcome studies of hypospadias surgery. [Copyright &y& Elsevier]

BACKGROUND: Hypospadias is one of the most common urogenital congenital anomalies affecting baby boys. Prevalence estimates in Europe range from 4 to 24 per 10,000 births, depending on definition, with higher rates reported from the United States. Relatively little is known about potential risk factors, but a role for endocrine-disrupting chemicals (EDCs) has been proposed. OBJECTIVE: Our goal was to elucidate the risk of hypospadias associated with occupational exposure of the mother to endocrine-disruptor chemicals, use of folate supplementation during pregnancy, and vegetarianism. DESIGN: We designed a case--control study of 471 hypospadias cases referred to surgeons and 490 randomly selected birth controls, born 1 January 1997--30 September 1998 in southeast England. Telephone interviews of mothers elicited information on folate supplementation during pregnancy and vegetarianism. We used a job exposure matrix to classify occupational exposure. RESULTS: In multiple logistic regression analysis, there were increased risks for self-reported occupational exposure to hair spray [exposed vs. nonexposed, odds ratio (OR) = 2.39; 95% confidence interval (CI), 1.40--4.17] and phthalate exposure obtained by a job exposure matrix (OR = 3.12; 95% CI, 1.04--11.46). There was a significantly reduced risk of hypospadias associated with of folate use during the first 3 months of pregnancy (OR = 0.64; 95% CI, 0.44--0.93). Vegetarianism was not associated with hypospadias risk. CONCLUSIONS: Excess risks of hypospadias associated with occupational exposures to phthalates and hair spray suggest that antiandrogenic EDCs may play a role in hypospadias. Folate supplementation in early pregnancy may be protective. [ABSTRACT FROM AUTHOR]

Reports on the development of an audit which aimed to identify strengths, weakness and opportunities with respect to information sharing and facilitating understanding between parents and medical/nursing staff for boys undergoing hypospadias repair. Variations in the practice used for treating hypospadias in Great Britain; Advantages of using focus groups as an approach to gathering data in a qualitative research; Difficulties associated with caring for a child in hospital identified by parents. INSETS: Box 1 Changes in practice related to information needs;Box2 Improvements in practice following audit feedback;Box 3 Proposals for research development around postoperative....

Compares dressing removal after hypospadias repair in Great Britain. Time interval between starting the process of dressing removal and having no dressing left in place; Assessment of the child's pain at different intervals; Issues about the most suitable environment to remove dressings.

Focuses on the challenges in hypospadias surgery in reconstructive urology in Great Britain. Objectives of hypospadias operations; Use of a parameatal-based flap in the procedure; Determination of distal strictures and fistula rate.

Examines the sexuality after hypospadias repair in Great Britain. Level of psychosexual disturbance in patience with hypospadias repair; Advantages of hypospadias repair on children at school age; Effect of sexual maturation on hypospadias surgery.

Background: In hypospadias, the aim of surgical treatment is to achieve both desirable functional and cosmetic outcomes; however, complications following surgery are common and 18% of boys require re-operation. In mild degrees of hypospadias, repair may be offered entirely to improve cosmesis, meaning parents should be fully informed of this and the potential for complications, during the consent process. Parents' decision-making may be aided by making them aware of how others in a similar position have felt about the decision that they made for their child. One method of measuring parental satisfaction is decisional regret (DR)., Objectives: To assess parental satisfaction following hypospadias surgery in the United Kingdom by assessing DR and to determine the feasibility of obtaining meaningful data via a mobile phone survey., Study Design: The National Outcomes Audit in Hypospadias database was commissioned by the British Association of Paediatric Surgeons to capture clinical information from hypospadias repairs. Following ethical approval (16/NW/0819), a text message was sent to mobile numbers in the database inviting participation in a questionnaire incorporating the validated DR scale (DRS). The primary outcome measure was mean DRS score, which was correlated with clinical information, a score of zero indicated no regret and 100 indicated maximum regret., Results: There were 340 (37%) responses. The median age at the primary procedure was 16 (interquartile range 13-20) months. No DR (score = 0) was detected in 186 (55% [95%CI 49-60]) respondents; however, moderate-to-severe DR (score = 26-100) was seen in 21 (6.2% [95%CI 3.6-8.7]) respondents. On multivariate analysis, a distal meatus, a small glans and developing complications requiring repeat surgery were all associated with increased levels of regret (Table). There was no association between DR and cases performed per surgeon., Discussion: Around half of respondents demonstrated no DR and postoperative complications requiring surgery were associated with the highest levels of DR, which is similar to a Canadian study. Lorenzo et al. however found that DR was associated with circumcision, which was undertaken in all boys; however, in this UK study, around a third of boys were circumcised and regret levels between those circumcised and those not circumcised were similar. The limitations of this work include the following: surgeons submitting their own data on complications and there is potential of selection bias between respondents and non-respondents as with any survey., Conclusions: Data from this study can be used to improve pre-operative counselling during the consent process. Smart mobile phone technology can be used successfully to distribute and collect parent-reported outcomes., (Copyright © 2020 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

A calendar of events on urology from May to June 2009 is presented including the International Meeting on Hypospadias Surgery in Great Britain from May 28 to 29, the Texas Urological Society Annual Meeting in Lake Tahoe, Nevada from June 4 to 6 and the American Urological Association (AUA) Foundation Community Cross Training in Urologic Wellness 2009 in Linthicum, Maryland on June 10.