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Centralisation of a hypospadias repair service – The Warwickshire experience

Authors
Journal
Journal of Plastic Reconstructive & Aesthetic Surgery
1748-6815
Publisher
Elsevier
Publication Date
Volume
60
Issue
1
Identifiers
DOI: 10.1016/j.bjps.2006.02.004
Keywords
  • Hypospadias
  • Centralisation
  • Complications

Abstract

Summary An audit of the hypospadias repair service provided in the county of Warwickshire has shown that centralising all referrals to a single surgeon who uses limited, well-practiced techniques, greatly improves outcome. Comparison to previous audit of the service, when provided by a number of surgeons in the region, shows complication rates dropping – fistulae occurrence reducing from 35.8% to 6.7% and urethral stricture rates showing similar improvement from 4.4% to 0%. Overall productivity increased, and referral out of region dropped from 13% to 0%. This provides definitive evidence that restructuring of a service already in place has decreased morbidity and increased efficiency to give results comparable to published data.

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