Primary hypospadias repair outcomes: results from a retrospective cohort of 292 children.

PURPOSE: Hypospadias surgery is challenging. Numerous techniques have been described with variable complication rates. The main objectives of our study were to evaluate the urethroplasty complication rate of primary hypospadias repair and to identify risk factors for complications. METHODS: We retrospectively evaluated the outcomes of all patients who underwent primary hypospadias repair in our department between January 2012 and December 2020. Demographic, anatomical, operative, and postoperative data were reported. Univariate and multivariate logistic regression analyses were performed to identify variables associated with complications. Statistical significance was set at p < 0.05. RESULTS: Of 292 patients, 203 (69.5%) had distal hypospadias, 63 (21.6%) had mid-penile hypospadias, and 26 (8.9%) had proximal hypospadias. The mean age at the time of surgery was 22.8 months. Seventy-eight patients (26.7%) had urethroplasty complications. The rate of complications was higher for proximal hypospadias (57.7%), onlay island flap (44.4%), and Koyanagi (75%) procedures. The mean follow-up duration was 29 months. Two predictors of complications were identified by multivariate analysis: catheterization duration and urethroplasty technique. The reoperation rate was 30.5%. CONCLUSION: Urethroplasty complications frequently occur after primary hypospadias repair. The complication rate was higher in proximal hypospadias. Catheterization duration and surgical technique were significant predictors of complications. A longer and more standardized follow-up is needed for a better assessment of hypospadias repair outcomes.

Psychophysiological, somatic, and affective changes across the menstrual cycle in women with panic disorder.

This study explored menstrual symptoms, somatic focus, negative affect, and psychophysiological responding across the menstrual cycle in women with panic disorder and controls. Women with and without panic disorder completed a psychophysiological task and self-report measures of menstrual symptoms, somatic focus, and negative affect on 4 occasions across 2 menstrual cycles (twice during intermenstrual and premenstrual phases). Women in the panic disorder group exhibited greater skin conductance magnitude and more frequent skin conductance responses to anxiety-provoking stimuli during the premenstrual phase than did controls. Compared to controls, women with panic disorder endorsed more severe menstrual symptoms relating to bodily sensations, anxiety sensitivity, state and trait anxiety, fear of body sensations, and illness-related concerns. The applicability of anxiety sensitivity to understanding the relation of menstrual reactivity and panic disorder is discussed.

The impact of anxiety sensitivity, bodily expectations, and cultural beliefs on menstrual symptom reporting: a test of the menstrual reactivity hypothesis.

According to the menstrual reactivity hypothesis, certain women report more severe as well as a greater number of menstrual symptoms due to accurate reports of physical symptoms and expectations (e.g., cultural beliefs, sex roles, bodily sensations). To test this hypothesis and to further examine the role that anxiety sensitivity plays in menstrual symptom reporting, women varying in levels of anxiety sensitivity completed measures of sex role socialization, menstrual attitudes, bodily preoccupations, affect, and fear of illness. To assess psychophysiological reactivity and the applicability of response styles theory to individuals varying in anxiety sensitivity, skin conductance was measured as participants engaged in a rumination or distraction task. In addition, participants completed a modified Stroop task consisting of anxiety, menstrual, and neutral words followed by a surprise recognition task. Retrospectively and prospectively, women high in anxiety sensitivity consistently reported more severe menstrual symptoms. High anxiety sensitivity women also reported preoccupation with bodily sensations and more negative attitudes toward illness, but did not differ from low anxiety sensitivity women on measures of menstrual attitudes or sex role socialization. While engaging in a rumination task, high anxiety sensitivity women exhibited more frequent skin conductance responses and greater skin conductance response magnitude than low anxiety sensitivity women. In addition, after the rumination task, high anxiety sensitivity women recognized more anxiety-related words from the Stroop task. Menstrual cycle phase had less of an impact than anxiety sensitivity level on the current results. Implications of these results for the menstrual reactivity hypothesis and rumination are discussed.

[Comparison between DSM III and CIM 9 in the data processing on computerized system. Study of 4000 records]. / Confrontation D.S.M. III et CIM 9 dans l'exploitation saisie sur système informatisé (1). Etude portant sur environ 4,000 dossiers.

The authors expose the results of a confrontation between ICD 9 and the D.S.M. III's classification published by APA. This work is the issue of a collected data system'use (S.D.P.A.) which is a basic tool for epidemiological programm, applied in military psychiatrics department (actually 18 services have got computer sets). It is evident that military structure (centralized dans homogeneous), and the size of the samples, are good conditions for psychiatric epidemiology. The authors recall the different stages and the difficulties on the field, for such a wide scale application. The use of two principal world-known classifications raise up unanticiped remarks: indeed, we consider the logical structure of D.S.M. III's axis I as better than ICD 9 classification. Meanwhile, the axis III, IV and V caused a disappointment, for both clinicians and programm's responsibles. In fact, there were some statistical biases and a little gain of informations. The former system (applied for 1976) was more efficient. Some hypothesis about that insufficient acceptability and reliability are proposed as also an important project for system's modifications from 1989.