The UK primary hypospadias surgery audit 2006-2007.

AIM: To find out what primary hypospadias surgery is being done in the United Kingdom and at what ages patients have surgery.

METHODS: On behalf of the British Associations of Paediatric Urologists, Paediatric Surgeons and Plastic, Reconstructive and Aesthetic Surgeons, paediatric surgeons/urologists, plastic surgeons and urologists were asked to record prospectively their data for 12 months, October 2006-September 2007.

RESULTS: There were 50 replies (response rate 50%, 79% of plastic surgeons and 40% of paediatric surgeons/urologists). Most patients had distal hypospadias. The total numbers of operations were 814 (paediatric surgeons/urologists), 436 (plastic surgeons) and 5 (one urologist). More than 20 operations a year were performed by 79% of paediatric surgeons/urologists and 35% of plastic surgeons. Both groups used a similar range of single-stage and two-stage operations. Patients' ages at surgery were less than two years for 68% of paediatric surgeons/urologists and two to four years for 60% of plastic surgeons.

CONCLUSIONS: In the UK most primary hypospadias surgery in children is performed by paediatric surgeons/urologists and plastic surgeons. Both groups of surgeons use a range of procedures. Many plastic surgeons are low volume operators. Most plastic surgeons operate on children two or more years old. Plastic surgeons should change their hypospadias service. All hypospadias surgeons should contribute to future prospective outcome studies of hypospadias surgery.