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Does Preputial Reconstruction Increase Complication Rate of Hypospadias Repair? 20-Year Systematic Review and Meta-Analysis

Overview of attention for article published in Frontiers in Pediatrics, April 2016
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Title
Does Preputial Reconstruction Increase Complication Rate of Hypospadias Repair? 20-Year Systematic Review and Meta-Analysis
Published in
Frontiers in Pediatrics, April 2016
DOI 10.3389/fped.2016.00041
Pubmed ID
Authors

Marco Castagnetti, Michele Gnech, Lorenzo Angelini, Waifro Rigamonti, Vincenzo Bagnara, Ciro Esposito

Abstract

We performed a systematic review of the literature on preputial reconstruction (PR) during hypospadias repair to determine the cumulative risk of preputial skin complications and the influence of PR on urethroplasty complications, namely, fistula formation and overall reoperation rate of the repair. A systematic search of the literature published after 06/1995 was performed in 06/2015 using the keyword "hypospadias." Only studies on the outcome of PR in children, defined as dehiscence of the reconstructed prepuce or secondary phimosis needing circumcision, were selected. A meta-analysis of studies comparing PR vs. circumcision was performed for the outcomes "hypospadias fistula formation" and "reoperation rate." Twenty studies were identified. Nineteen reported the outcome of PR in 2115 patients. Overall, 95% (2016/2115) of patients undergoing PR had distal hypospadias. The cumulative rate of PR complications was 7.7% (163/2115 patients), including 5.7% (121/2115 patients) preputial dehiscences and 1.5% (35/2117 reported patients) secondary phimoses needing circumcision. A meta-analysis of seven studies comparing patients undergoing PR vs. circumcision showed no increased risk of urethral fistula formation associated with PR, odds ratio (OR) (Mantel-Haenszel, Fixed effect, 95% CI), 1.25 (0.80-1.97). Likewise, two studies comparing the overall reoperation rate did not show an increased risk of reoperation associated with PR, OR (Mantel-Haenszel, Random effect, 95% CI), 1.27 (0.45-3.58). PR carries an 8% risk of specific complications (dehiscence of reconstructed prepuce or secondary phimosis needing circumcision), but does not seem to increase the risk of urethroplasty complications, and the overall reoperation rate of hypospadias repair.

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Geographical breakdown

Country Count As %
Switzerland 1 5%
Unknown 19 95%

Demographic breakdown

Readers by professional status Count As %
Other 4 20%
Student > Master 3 15%
Student > Bachelor 2 10%
Researcher 2 10%
Student > Ph. D. Student 2 10%
Other 1 5%
Unknown 6 30%
Readers by discipline Count As %
Medicine and Dentistry 8 40%
Biochemistry, Genetics and Molecular Biology 2 10%
Agricultural and Biological Sciences 1 5%
Unknown 9 45%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 April 2016.
All research outputs
#18,453,763
of 22,865,319 outputs
Outputs from Frontiers in Pediatrics
#3,359
of 5,991 outputs
Outputs of similar age
#218,953
of 299,113 outputs
Outputs of similar age from Frontiers in Pediatrics
#33
of 41 outputs
Altmetric has tracked 22,865,319 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
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