These authors identified all children undergoing NHS hypospadias surgery between 1999 and 2009 in England using the hospital episode statistic database and looked at repair types and complications. High-volume centres (24/75) were classified as such if they did more than 20 operations per year. Across 75 centres 23,962 operations were carried out on 17,554 children. The median case load was 11 (range 4-42) per year. Median age at operation was 21 months (15-38 months). The overall complication rate was 18.1% (low volume centres 17.5% vs. high volume centres 25%). The degree of hypospadias was not analysed as 45.9% did not have a classification that could be identified, however staged operations were not associated with higher complication rates. The authors highlighted that there might be a number of confounding factors in their study, including case mix, surgeons per centre, staged procedures. They concluded that all centres should assess their results against the benchmark of the high volume centres with a complication rate of 10%. 

Hypospadias surgery in England: higher volume centres have lower complication rates.
Wilkinson D, Green P, Berlinger S, et al.
Share This
Henrik Steinbrecher

Southampton University Hospital NHS Trust

View Full Profile