Journal of pediatric urology · 2026
Long-term outcomes of Koff urethral mobilization and advancement in pediatric distal hypospadias and reoperations: A 15-year single-center experience.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Zarfati Angelo, Gallo Emanuela, Tulelli Berenice, Mouriquand Pierre, Bidault Valeska, Demede Delphine
Аннотация
INTRODUCTION: Koff urethral mobilization and advancement has shown encouraging results in case of distal hypospadias even though related literature lacks large series and data on long-term follow-up.
OBJECTIVE: To evaluate the long-term outcomes of Koff urethroplasty in pediatric distal hypospadias, including both primary and redo cases. A secondary objective was to assess whether puberty increases the risk of late complications.
METHODS: Retrospective single-center review of all pediatric patients who underwent Koff urethroplasty for distal hypospadias between 2005 and 2020. Perioperative and long-term outcomes were analyzed. Subgroup analyses compared primary versus redo procedures and prepubertal versus postpubertal follow-up.
RESULTS: A total of 436 (33 %) patients were included (351 primary [81 %], 85 redo [19 %]). Median age at surgery was 1.7 years (range: 0.8-16). Early postoperative complications occurred in 3 % of cases (n = 15), with major complications (Clavien-Dindo ≥ IIIa) in 0.6 % (n = 3). At a median follow-up of 23 months, 89 % of patients had uneventful outcomes. Late complications occurred in 11 %, with 6.9 % requiring further surgery. Redo procedures were associated with significantly higher rates of meatal stenosis (11.3 % vs. 1.8 %), non-apical meatus (16.4 % vs. 0.9 %), and urethral fistula (3.7 % vs. 0 %). Among 60 patients followed into puberty, the overall post-pubertal complication rate remained low at 4.7 %, although certain complications were more frequent than in the prepubertal period. Specifically, aesthetic concerns occurred in 13.3 % versus 4.9 %, meatal stenosis in 8.1 % versus 2.9 %, and reoperations in 13.3 % versus 5.8 % of patients.
CONCLUSIONS: The Koff urethral mobilization and advancement technique provides excellent perioperative safety and durable outcomes, with very low rates of fistula and stenosis. Long-term follow-up into adulthood is essential to detect delayed complications. These findings support Koff urethral advancement as a first-line surgical option in appropriately selected pediatric patients with distal hypospadias.
OBJECTIVE: To evaluate the long-term outcomes of Koff urethroplasty in pediatric distal hypospadias, including both primary and redo cases. A secondary objective was to assess whether puberty increases the risk of late complications.
METHODS: Retrospective single-center review of all pediatric patients who underwent Koff urethroplasty for distal hypospadias between 2005 and 2020. Perioperative and long-term outcomes were analyzed. Subgroup analyses compared primary versus redo procedures and prepubertal versus postpubertal follow-up.
RESULTS: A total of 436 (33 %) patients were included (351 primary [81 %], 85 redo [19 %]). Median age at surgery was 1.7 years (range: 0.8-16). Early postoperative complications occurred in 3 % of cases (n = 15), with major complications (Clavien-Dindo ≥ IIIa) in 0.6 % (n = 3). At a median follow-up of 23 months, 89 % of patients had uneventful outcomes. Late complications occurred in 11 %, with 6.9 % requiring further surgery. Redo procedures were associated with significantly higher rates of meatal stenosis (11.3 % vs. 1.8 %), non-apical meatus (16.4 % vs. 0.9 %), and urethral fistula (3.7 % vs. 0 %). Among 60 patients followed into puberty, the overall post-pubertal complication rate remained low at 4.7 %, although certain complications were more frequent than in the prepubertal period. Specifically, aesthetic concerns occurred in 13.3 % versus 4.9 %, meatal stenosis in 8.1 % versus 2.9 %, and reoperations in 13.3 % versus 5.8 % of patients.
CONCLUSIONS: The Koff urethral mobilization and advancement technique provides excellent perioperative safety and durable outcomes, with very low rates of fistula and stenosis. Long-term follow-up into adulthood is essential to detect delayed complications. These findings support Koff urethral advancement as a first-line surgical option in appropriately selected pediatric patients with distal hypospadias.