An International Delphi Based Study for Developing A Core Outcome Set For Hypospadias Surgery.

Abstract

Introduction Explicit outcomes routinely measured across the life span following hypospadias surgery, defined by a core outcome set (COS), will harmonize and overcome reporting heterogeneity. Methods Age specific outcomes identified in a literature review were presented in a three round Delphi survey. Participants (professionals, parents and patients) were encouraged to suggest outcomes in the first Delphi round. In subsequent rounds participants were asked to choose and rank up to five preferred outcomes for each age. To be deemed core, an outcome needed over 70% of votes in a round. Results Professionals were mainly paediatric urologists (round 1, 2, 3: n=57 (77 %), 39 (78%), 35 (81%)). The response rates from parents/patients (round 1, 2, 3: n= 17, 5, 3) were low. In young boys (<6 years, 6-10 years) four core outcomes were identical (voiding, fistula, re-operation and urethral stricture). Core outcomes in boys aged 11-16 years (cosmesis, curvature, voiding, stricture and psychosocial status) and boys >16 years (cosmesis, curvature, erection, voiding and psychosexual development) varied more. Conclusion Outcomes to include in a COS were consistent in younger boys. A larger variety was observed in older boys and reflects less clarity on relevant outcomes.