Summary
An audit of the hypospadias repair service provided in the county of Warwickshire
has shown that centralising all referrals to a single surgeon who uses limited, well-practiced
techniques, greatly improves outcome. Comparison to previous audit of the service,
when provided by a number of surgeons in the region, shows complication rates dropping
– fistulae occurrence reducing from 35.8% to 6.7% and urethral stricture rates showing
similar improvement from 4.4% to 0%. Overall productivity increased, and referral
out of region dropped from 13% to 0%. This provides definitive evidence that restructuring
of a service already in place has decreased morbidity and increased efficiency to
give results comparable to published data.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Plastic, Reconstructive & Aesthetic SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- History of hypospadiology.
- Urogenital reconstruction, penile hypospadias.
- Paulus Aegineta, a seventh century encyclopaedist and surgeon. His role in the history of plastic surgery.Plast Reconstr Surg. 2001 December; 108: 2072-2079
- The history of hypospadias.Pediatr Surg Int. 1997 February; 12: 81-85
- A versatile two-stage hypospadias repair.Br J Plast Surg. 1995; 48: 345-352
- Tubularized, incised plate urethroplasty for distal hypospadias.J Urol. 1994 February; 151: 464-465
- MAGPI: a procedure for subcoronal hypospadias.Urol Clin North Am. 1981 October; 8: 513-519
- A 5-year audit of trainees experience and outcomes.Br J Plast Surg. 1998; 51: 370-375
- A modified Bretteville technique for hypospadias.Br J Plast Surg. 1996; 49: 223-227
- Two-stage hypospadias repair: an audit in a district general hospital.Br J Plast Surg. 2003; 56: 752-758
- Provision of services for cleft lip and palate in England and Wales.BMJ. 1994; 309: 1552
Article info
Publication history
Published online: May 24, 2006
Accepted:
February 8,
2006
Received:
January 17,
2005
Identification
Copyright
© 2006 The British Association of Plastic Surgeons. Published by Elsevier Inc. All rights reserved.