[The efficacy of surgical treatment of hypospadias: analysis of hospital data from Lazio region during the three year period (1996-8)].

INTRODUCTION: The aim of this study is to assess effectiveness of surgical treatment for hypospadia in the Regione Lazio (Italy). Hospital discharge data concerning surgical repair of hypospadia between 1996-1998 were analysed in order to: 1. estimate the trend of demand for hypospadia treatment; 2. correlate clinical results with the type of Surgical Unit of admission (general pediatric, urological, plastic); 3. correlate surgical results with the workload of the Unit; 4. quantify the general risk of a secondary treatment. METHODS: The source of data was the Hospital Information System of the Regione Lazio. Cases have been grouped according to Health District, age at first operation, interval to re-hospitalization after the first treatment for hypospadia. RESULTS: Age at first operation progressively declined in the last years. The annual risk of readmission and reoperation after the first surgical treatment, calculated on a group of 521 cases in 1996, are respectively 6.6% and 5%. CONCLUSIONS: The demand for hypospadia surgery in children was, as expected, stable in the time. However, a tendency to an earlier correction has been observed, mainly in the first and second year of life. Nearly all (99%) of the surgery for hypospadia in the Regione Lazio is performed in four hospitals; one of them accounts for three quarters of the workload. During the observed period a progressive reduction of hospital stay was seen. In the hospital with the best results in term of surgical efficiency, a significant number of patients is treated on a Day Surgery basis. Institutions treating less than 50 cases per year show a significantly high rate of re-hospitalisation within 12 months.