Hypospadias Clinical Trial
Official title:
Assessment of Postoperative Pain in Boys Undergoing Hypospadias Repair
One of the most common pediatric urology procedures is hypospadias repair, a surgery to correct curvature of the penis and move the urethral meatus into the glans. A survey of pediatric urologists demonstrated that 72% of pediatric urologists prescribe opioid pain medication following the procedure. Using a validated questionnaire, the investigators aim to quantify how much opioid pain medication boys undergoing hypospadias repair require and if opioid pain medication can be eliminated from the routine postoperative medication regimen.
Postoperative pain scores, as measured by the Parents' Postoperative Pain Measure scale, will
not be statistically different in boys who receive opioid pain medication postoperatively
compared to boys who do not.
The long-term objectives of this study are to understand if pre and postoperative counseling
and education along with proper surgical technique will result in less opioid prescriptions
following hypospadias repair.
Children with suspected hypospadias will be seen and examined in clinic and offered surgery
if appropriate. If the families elect for surgery, this will be performed by one of the
investigators between 6-12 months of age. The surgical technique may vary among the
investigators. Patients with severe hypospadias may require multiple surgeries for
correction.
On the day of surgery, patients will be randomized to receive one of two pain medication
regimens:
1. Acetaminophen (15 mg/kg) q6h and Ibuprofen (10 mg/kg) q6h
2. Acetaminophen q6h, Ibuprofen q6h, and Oxycodone 0.1 mg/kg q6h prn breakthrough pain for
10 doses Home dosing regimens will be started six hours after the last hospital dose of
each medication. The families will be instructed as to when they can give oral
medications at home. Lastly, families of both children in both groups will be instructed
to contact the clinic or urologist on call if their children are experiencing
uncontrolled pain. This may necessitate evaluation in person or adjustment of the
current pain regimen. Any deviation from to prescribed pain regimen will be recorded for
the study.
Patients will be contacted by phone at 1, 3, and 5 days postoperatively and given a validated
questionnaire, the Parents' Postoperative Pain Measure scale, to objectively quantify how
much discomfort boys in both groups experienced.
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