Abbas Tariq
Urology Division, Department of Surgery, Sidra Medicine, Doha P.O. Box 26999, Qatar.
College of Medicine, Qatar University, Doha P.O. Box 2713, Qatar.
Diagnostics (Basel). 2025 Aug 20;15(16):2087. doi: 10.3390/diagnostics15162087.
: Hypospadias is a common congenital anomaly in boys, marked by ectopic urethral meatus and a wide range of anatomical variants such as chordee and atypical glans morphology. Despite advancements in surgical techniques, complication rates remain high and unpredictable due to heterogeneity in anatomy and a lack of standardized preoperative assessments. Retrospective studies suggest associations between specific anatomical features and postoperative complications; however, high-quality prospective, multicenter evidence is currently lacking. : The PREDICT-H (Prospective Research on Essential Determinants Influencing Complication Trends in Hypospadias) study is a multicenter, prospective cohort study aiming to enroll approximately 1450 boys aged 1-12 years undergoing primary hypospadias repair at ten or more tertiary pediatric urology centers. A standardized preoperative assessment protocol will document detailed anatomical parameters, including urethral plate width and length, glans size, meatal location, chordee severity, and GMS score. Intraoperative variables and surgical techniques will be recorded. Postoperative outcomes, including urethrocutaneous fistula, meatal stenosis, and recurrent chordee, will be assessed at ≥6 months follow-up. Statistical analyses will include multivariate logistic regression and advanced modeling to identify independent predictors and develop a validated risk prediction nomogram. Interobserver reliability of anatomical assessments will also be evaluated. : As this is a study protocol, results are not yet available. Data collection is ongoing and will be analyzed upon completion of the planned follow-up period. The primary outcome will be the incidence of postoperative complications and the development of a predictive nomogram for individualized risk estimation. : The PREDICT-H study is designed to provide robust, prospective evidence on the anatomical determinants of postoperative complications in hypospadias surgery. The development of a validated, clinically applicable risk prediction tool could standardize preoperative assessment and enhance individualized surgical planning. Findings from this study are expected to support evidence-based practice and inform future clinical guidelines.
尿道下裂是男孩常见的先天性异常，其特征为尿道外口异位以及多种解剖变异，如阴茎下弯和非典型龟头形态。尽管手术技术有所进步，但由于解剖结构的异质性和缺乏标准化的术前评估，并发症发生率仍然很高且难以预测。回顾性研究表明特定解剖特征与术后并发症之间存在关联；然而，目前缺乏高质量的前瞻性、多中心证据。
PREDICT-H（尿道下裂并发症趋势影响因素的前瞻性研究）研究是一项多中心、前瞻性队列研究，旨在纳入约1450名年龄在1至12岁之间、在十个或更多三级儿科泌尿外科中心接受原发性尿道下裂修复手术的男孩。标准化的术前评估方案将记录详细的解剖参数，包括尿道板宽度和长度、龟头大小、尿道口位置、阴茎下弯严重程度以及GMS评分。术中变量和手术技术将被记录。术后结局，包括尿道皮肤瘘、尿道口狭窄和复发性阴茎下弯，将在随访≥6个月时进行评估。统计分析将包括多变量逻辑回归和高级建模，以识别独立预测因素并开发经过验证的风险预测列线图。还将评估解剖评估的观察者间可靠性。
由于这是一项研究方案，目前尚无结果。数据收集正在进行中，将在计划的随访期结束后进行分析。主要结局将是术后并发症的发生率以及开发用于个体化风险估计的预测列线图。
PREDICT-H研究旨在为尿道下裂手术术后并发症的解剖学决定因素提供有力的前瞻性证据。开发经过验证的、临床适用的风险预测工具可以使术前评估标准化并加强个体化手术规划。预计本研究的结果将支持循证实践并为未来的临床指南提供参考。
