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Instructional Course

Instructional Course - Available with the Platinum and Silver packages or Individual Course Ticket

064IC - Getting It Right the First Time: An Evidence-Based Approach to Primary Hypospadias Repair

Sunday, May 15, 2022

1:30 PM – 3:30 PM

Location: Room 219

Instructional Course Director(s)

WS

Warren Thomas Snodgrass, MD

Hypospadias Surgeon
Hypospadias Specialty Center

Instructional Course Faculty(s)

Nicol Corbin Bush, MD, MSC

Co-director, Hypospadias Specialty Center
Hypospadias Specialty Center

Learning Objectives:

Define the 3 etiologies of ventral curvature and discuss the most reliable means for straightening varying degrees of ventral curvature.straightening varying degrees of ventral curvature
Describe a modern algorithm for primary hypospadias repair, comprising the techniques that consistently achieve the best results with the fewest complications.
Identify optimal methods for urethroplasty and glansplasty, especially in boys with a small glans, and state why mattress glans sutures should be avoided.
Identify hypospadias complications, including recurrent penile curvature, urethroplasty complications and short ventral skin, and describe technical errors that result in them.
Implement a personal quality assessment and improvement plan for hypospadias practice.

The goal of hypospadias repair is to transform the abnormal anatomy of the condition into a normal penis. This evidence-based course describes a modern algorithm to achieve that goal regardless of the extent of hypospadias, from distal to the most severe perineal cases. It recognizes that this surgery is demanding and that recommendations for how to do it are often confusing or contradictory. Therefore, the course emphasizes optimal performance of key technical steps, including straightening ventral curvature, urethroplasty/glansplasty, barrier layers and aesthetic skin closure to get the operation right the first time. Expected success rates for distal and proximal repairs are reviewed with the aim of establishing performance standards for hypospadias surgeons. The course directors draw on their extensive experience reoperating after unsuccessful repairs done elsewhere to highlight common errors which result in complications. They will also describe simple means for surgeons to determine and monitor their own outcomes and make improvements as needed. All urologists repairing hypospadias, including the course directors, can get better, and this course is primarily designed to share observations and stimulate discussion to benefit experienced hypospadias surgeons as well as current and future pediatric urology fellows.