{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T23:12:16Z","timestamp":1788995536024,"version":"build-2803163510"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>\n                    This multicenter study aimed to establish a quantitative, individualized surgical decision algorithm for pediatric hypospadias by analyzing multicenter penile anatomical data, surgical approaches, and follow-up outcomes. To achieve this purpose, clinical data from 1500 primary hypospadias cases across 17 tertiary centers in China (December 2018 to September 2021) were retrospectively reviewed, with patients stratified into urethral plate preservation group (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 715) and transection group (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 785). Using multivariate logistic regression, key predictors for intraoperative urethral plate transection were identified, and morphometric parameters were analyzed to guide surgical selection. This analysis led to the development of a predictive nomogram and risk stratification thresholds, which were subsequently validated. The results demonstrated that significant predictors of transection included glans length (odds ratio [OR]: 1.17, 95% confidence interval [CI]: 1.07\u20131.29), glans width (OR: 0.35, 95% CI: 0.29\u20130.43), and penile curvature (OR: 1.07, 95% CI: 1.06\u20131.08), with the nomogram showing excellent discrimination (area under the receiver operating characteristic curve [AUC]: 0.914 in training and 0.87 in validation). Furthermore, for urethral plate preservation, a urethral plate width threshold of 4.25 mm differentiated optimal candidates for tubularized incised plate urethroplasty (width \u22654.25 mm) versus onlay island flap (width &lt;4.25 mm). Notably, in transected cases, a urethral defect length of &gt;3.55 cm was associated with higher complication rates in single-stage repairs (45.8%\n                    <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                    33.4%,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.05), favoring staged approaches. This algorithm integrates preoperative morphometrics and intraoperative measurements to provide objective, quantifiable guidance for individualized surgical planning, particularly benefiting less experienced surgeons.\n                  <\/jats:p>","DOI":"10.4103\/aja202571","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T11:00:10Z","timestamp":1768302010000},"page":"259-266","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Development of individualized surgical strategies for pediatric hypospadias: a multicenter penile morphometric analysis"],"prefix":"10.4103","volume":"28","author":[{"given":"Yi-Wei","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Urology, Beijing Children\u2019s Hospital, Capital Medical University, National Center for Children\u2019s Health, Beijing 100045, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong-Cheng","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Urology, Beijing Children\u2019s Hospital, Capital Medical University, National Center for Children\u2019s Health, Beijing 100045, China"},{"name":"Department of Urology, Children\u2019s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hospital of Beijing Children\u2019s Hospital, Urumqi 830054, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Man","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Sichuan Academy of Medical Sciences, Sichuan Provincial People\u2019s Hospital (SAMSPH), Chengdu 610072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu-Gang","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu 610044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology, Shengjing Hospital of China Medical University, Shenyang 110004, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology, Anhui Children\u2019s Hospital, Hefei 230022, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology and General Thoracic Surgery, Affiliated Hospital of Zunyi Medical University (Guizhou Children\u2019s Hospital), Zunyi 563003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing-Ti","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, Xi\u2019an Children\u2019s Hospital, Xi\u2019an 710002, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu-Hui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, Shanxi Children\u2019s Hospital, Taiyuan 030013, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shou-Lin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, Shenzhen Children\u2019s Hospital, Shenzhen 518038, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Da-Wei","family":"He","sequence":"additional","affiliation":[{"name":"Department of Urology, Children\u2019s Hospital of Chongqing Medical University, Chongqing 400015, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Bo","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Urology, Children\u2019s Hospital of Jiangxi Province, Nanchang 330006, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Urology, Shanghai Children\u2019s Hospital, Shanghai 200062, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Urology, Tianjin Children\u2019s Hospital, Tianjin 300134, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-Fang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Urology, Henan Children\u2019s Hospital, Zhengzhou 450018, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian-Guo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Inner Mongolia Maternal and Child Health Hospital, Hohhot 010020, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"R1-20260430","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1038\/s41443-022-00563-7","article-title":"Hypospadias:lessons learned. 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