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Review
. 2023 Jul 6;39(1):226.
doi: 10.1007/s00383-023-05505-y.

Hypospadias management in children with anorectal malformation: a multidisciplinary single center experience

Valentina Forlini  1   2 , Chiara Pellegrino  3 , Maria Luisa Capitanucci  1 , Federico Beati  4 , Barbara Daniela Iacobelli  4 , Andrea Conforti  4 , Maria Laura Sollini  5 , Beatrice Turchi  1   6 , Marco Agamennone  1   2 , Carlo Efisio Marras  7 , Giacomo Esposito  7 , Paolo Palma  7 , Gessica Della Bella  8 , Rossella D'urzo  8 , Enrico Castelli  9 , Pietro Bagolan  10 , Giovanni Mosiello  1
Affiliations
Review

Hypospadias management in children with anorectal malformation: a multidisciplinary single center experience

Valentina Forlini et al. Pediatr Surg Int. .

Abstract

Anorectal malformation (ARM) is often associated to other congenital malformations, requiring a tailored management. Hypospadias' treatment in ARM is poorly described. Aim of study is to describe our experience in ARM-hypospadias patients especially in relation to occult spinal dysraphism (OSD). ARM patients treated from 1999 to 2022 were retrospectively reviewed, selecting male with hypospadias. Clinical data, hypospadias's severity, ARM sub-type (Group A: perineal fistula; Group B: urethral fistula, bladder fistula, no fistula), OSD, other associated malformations, NLUTD were evaluated. Exclusion criteria: uncomplete data. Among 395 ARMs, 222 were males, 22 (10%) had hypospadias. Two patients were excluded. Group A: 8 patients, Group-B: 12. Hypospadias: proximal 9 patients, distal 11. Neuro-urological evaluation was performed before hypospadias repair. Eleven patients (55%) had OSD. Four OSD patients presented NLUTD and underwent detethering and CIC (two via cystostomy button, two via appendicostomy); two of them had hypospadias repaired. All proximal hypospadias underwent two stages of surgery. Distal hypospadias was corrected in 4/11 cases. Hypospadias is quite common in ARM patients and its surgical management must be scheduled considering the possible OSD and NLUTD, with the possible need for intermittent catheterization. Complexity of ARM and hypospadias appears to be related to each other.

Keywords: Anorectal malformation; Hypospadias; Neurogenic bladder; Occult spinal dysraphism.

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