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S14-12
(P)
PATIENT RACE DOES NOT IMPACT THE INCIDENCE OF HYPOSPADIAS
COMPLICATIONS IN PATIENTS STANDARDIZED BY GLANS-URETHAL MEATUS-
SHAFT (GUMS) SCORE
Michael GARCIA-ROIG
1
, James ELMORE
1
, Angela ARLEN
1
, Jonathan HUANG
1
, Traci LEONG
2
and Andrew KIRSCH
1
1) Emory University School of Medicine, Department of Pediatric Urology, Atlanta, USA - 2) Emory University Rollins
School of Public Health, Biostatistics and Bioinformatics, Atlanta, USA
PURPOSE
The GUMS score reliably correlates with hypospadias severity and postoperative complications. Racial differences in
postoperative wound healing have been described in non-urologic surgery. We aimed to determine whether 1) racial
differences exist in hypospadias severity (GMS score), and 2) patient race predicts postoperative complications.
MATERIAL AND METHODS
Patients undergoing primary hypospadias repair (2011-2014) were prospectively classified by GUMS score, a 4-point
scale (higher score=increased severity): G– glans size/urethral plate quality, M– meatal location, S– shaft
curvature. Demographics, complications (urethrocutaneous fistula(UCF), stricture, glans dehiscence, recurrent chordee,
meatal stenosis), and parent self-reported race (white, black/African-American(AA), Asian(A), Hispanic(H), unknown(U))
were recorded. Asians/Hispanics were combined for analysis. The impact of race on postoperative complications was
evaluated by uni/multivariate analysis.
RESULTS
299 boys, mean age 12±13 months, underwent primary hypospadias repair with mean GMS 7±2.3 (G 2.2±0.9, M
2.4±1.0, S 2.4±1.0). A/H group included 11-A, 17-H, and 5-U. Mean GMS score by race included 133 white patients,
6.5±2.2 (G 2.1±0.8, M 2.2±0.9, S 2.3±0.9), 133 AA, 7.2±2.3 (G 2.2±0.8, M 2.5±1.0, S 2.5±1.0), and 33 A/H,
7.6±2.6 (G 2.3±1.0, M 2.6±1.0, S 2.7±1.0). Meatus(p=0.007), curvature(p=0.04) and total GMS(0.008) were
significantly higher in A/H patients.
At least one complication occurred in 40 boys(13.7%) and correlated with total GMS(p< 0.001), however not with
AUH(p=0.70) or AA race(p=0.06). UCF occurred in 23(7.7%), and correlated with total GUMS(p=0.005), but not
A/H(p=0.74) or AA race(p=0.12).
Beta(SE)
OR 95%CI
p-value
ANY COMPLICATION
GUMS
0.39(0.09) 1.48 (1.25,1.76) <0.001
Race
-White(ref)
-AA
-0.87(0.45) 0.42 (0.17,1.02) 0.06
-AUH
-0.23(0.60) 0.79 (0.25,2.55) 0.70
URETHROCUTANEOUS FISTULA
GUMS
0.27(0.10) 1.31 (1.09,1.59) 0.005
Race
-White(ref)
-AA
-0.84(0.54) 0.43 (0.15,1.24) 0.12
-AUH
-0.23(0.69) 0.79 (0.21,3.05) 0.74
CONCLUSIONS
GUMS reliably correlates with postoperative complications and UCF. Our findings suggest postoperative hypospadias
complications cannot be predicted by patient race.