Outcome after Hypospadias Repair: Evaluation Using the Hypospadias Objective Penile Evaluation Score

Eur J Pediatr Surg. 2018 Jun;28(3):268-272. doi: 10.1055/s-0037-1602252. Epub 2017 May 15.

Abstract

Introduction: The Hypospadias Objective Penile Evaluation Score (HOPE-Score) is a concise and reproducible way to describe hypospadias severity. We classified boys undergoing primary hypospadias repair to determine the correlation between the HOPE-Score and the severity of hypospadias first and the outcome after surgery second.

Materials and methods: Patients who underwent primary hypospadias repair from 2005 to 2014 were identified. An independent physician assessed retrospectively the HOPE-Score, using photographies of the patients before, after primary surgery, and after all necessary surgeries. The correlation between the HOPE-Score and the severity of hypospadias, on the one hand, and the outcome after surgery, on the other hand, were analyzed.

Results: The HOPE-Score was assessed preoperatively for 79 boys, postoperatively for 66, and after all necessary surgeries for 21 patients. Mean HOPE-Score reached 30.2 ± 5.9 before surgery, 42.2 ± 6.1 after primary surgery, and 43.7 ± 3.4 after all necessary surgeries. A significant correlation between the HOPE-Score and the severity of hypospadias before surgery was observed. The boys with glanular hypospadias scored significantly higher (36.3 ± 5.4) than those with distal (29.6 ± 4.4) and proximal hypospadias (21.1 ± 3.5). Furthermore, a significant correlation between the HOPE-Score and the outcome after hypospadias repair was observed. Patients who needed no reintervention after primary hypospadias repair scored significantly higher postoperatively (45.1 ± 5.4) than those who needed a second (40.8 ± 4.2) or more than two surgeries (36.9 ± 7.4).

Conclusion: The HOPE-Score is a good system to assess the severity of hypospadias and the cosmetic outcome after hypospadias repair.

MeSH terms

  • Child
  • Child, Preschool
  • Follow-Up Studies
  • Humans
  • Hypospadias / diagnosis
  • Hypospadias / surgery*
  • Infant
  • Infant, Newborn
  • Male
  • Retrospective Studies
  • Severity of Illness Index*
  • Treatment Outcome
  • Urologic Surgical Procedures, Male*