{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:57:14Z","timestamp":1790571434471,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Complex hypospadias (CH) is a challenging congenital anomaly that requires comprehensive surgical, genetic and endocrine evaluation. This study evaluates the implementation of a pre\u2010operative clinical checklist to standardise care and streamline a multidisciplinary team (MDT) approach to CH management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort analysis was conducted on 50 children with CH managed at two tertiary paediatric hospitals between 2016 and 2024. A structured pre\u2010operative checklist was introduced in 2021 to standardise genetic, endocrine and anatomical evaluations and to facilitate asynchronous MDT review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 50 children evaluated (median age 18\u2009months; median GMS score 11), 35 were managed after the checklist's introduction. The checklist enabled 77% (27\/35) of these patients to bypass a full, synchronous MDT discussion. Clinical assessments revealed renal anomalies in 11% and proteinuria in 19%. Testing identified suboptimal testosterone responses in 4% and pathogenic genetic variants in 15% (7\/46), with genetic testing directly influencing clinical decision\u2010making in three patients. Among the 38 patients who underwent index surgical repair, 32% required revision surgery. Short\u2010term surgical reintervention was driven by anatomical complexity rather than by underlying genetic or endocrine abnormalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Implementing a pre\u2010operative checklist for the CH streamlines the MDT review process, we hypothesise reduces the risk of missing important investigations, and supports a more structured approach to informed surgical consent. While genetic and endocrine findings are crucial for diagnosis, anatomical severity remains the primary predictor of early surgical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70498","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T07:24:55Z","timestamp":1785137095000},"page":"1706-1711","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Checklist\u2010Based Approach to Complex Hypospadias: Surgical, Genetic and Endocrine Insights From a Multidisciplinary Model"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4371-1409","authenticated-orcid":false,"given":"Bandar","family":"Alsahn","sequence":"first","affiliation":[{"name":"Department of Urology The Children's Hospital at Westmead  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Nagpure","sequence":"additional","affiliation":[{"name":"Department of Urology The Children's Hospital at Westmead  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Sharpin","sequence":"additional","affiliation":[{"name":"Department of Urology The Children's Hospital at Westmead  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grahame","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Urology The Children's Hospital at Westmead  Sydney Australia"},{"name":"Discipline of Child and Adolescent Health, Faculty of Medicine and Health The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A.","family":"Sandaradura","sequence":"additional","affiliation":[{"name":"Discipline of Child and Adolescent Health, Faculty of Medicine and Health The University of Sydney  Sydney Australia"},{"name":"Department of Clinical Genetics The Children's Hospital at Westmead  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann M.","family":"Maguire","sequence":"additional","affiliation":[{"name":"Discipline of Child and Adolescent Health, Faculty of Medicine and Health The University of Sydney  Sydney Australia"},{"name":"Institute of Endocrinology and Diabetes The Children's Hospital at Westmead  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0910-6192","authenticated-orcid":false,"given":"Kristen","family":"Neville","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Sydney Children's Hospital  Sydney Australia"},{"name":"School of Clinical Medicine University of NSW  Sydney 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