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TH
CONGRESS OF THE ESPU
09:12–09:15
S14-7 (PP)
★
GLANS GROOVE DEPTH, NOT PREOPERATIVE
TESTOSTERONE STIMULATION, IS THE MAIN RISK FACTOR
FOR COMPLICATIONS POST-TIP REPAIR
Luis BRAGA
1
, Adriana DEKIRMENDJIAN
2
, Melissa MCGRATH
2
,
Bethany EASTERBROOK
3
, Kizanee JEGATHEESWARAN
3
and Armando J. LORENZO
4
1) McMaster University - McMaster Children’s Hospital, Department of Surgery / Urology, Hamilton, CANADA -
2) McMaster University, McMaster Pediatric Surgery Research Collaborative, Hamilton, CANADA - 3) McMaster
University, McMaster Pediatric Surgery Research Collaborative, Hamilton, CANADA - 4) The Hospital for Sick Children,
Paediatric Urology, Toronto, CANADA
INTRODUCTION AND OBJECTIVE
Effects of preoperative testosterone stimulation (PTS) on complications following TIP repair remain
unclear. We conducted a prospective study to examine the association between glans groove
(a surrogate for urethral plate[UP]quality) and PTS, with hypospadias complications.
MATERIAL AND METHODS
Of a prospectively collected hypospadias database (n=536), consecutive TIP repairs from
2008-2016 were selected. Staged repairs, other techniques and redos were excluded. Primary
outcome was postoperative complication rate(fistula, glans dehiscence and meatal stenosis). Uni/
multivariable analysis (binary logistic and cox proportional regressions)were performed.
RESULTS
Of 312 patients, 235 (75%) had distal, 48 (15%) midshaft and 39 (9%) proximal hypospadias.
Median age at surgery was 16 (3-171)months and mean follow-up was 16±15 months. Mean GMS
score at initial exam was higher in PTS group vs. no PTS group (7.5±1.6 vs. 5.4±1.3,p<0.01). Mean
GMS score for PTS patients decreased at surgery but was still significantly higher than that of non-
PTS (6±1.4 vs. 5.5±1.3,p<0.01). Overall complication rate was 12% (9%-distal, 17%-midshaft, and
31%-proximal) and median time to complication was 2.5 months (0-63). On logistic and cox propor-
tional regressions,glans width and PTS were not identified as risk factors;only a combined variable
of glans groove depth/UP quality was significantly associated with TIP complications (p=0.01).
Multivariable
Complications(n=38)(%) HR(95%CI)
p-value
Preoperative Testosterone
Stimulation
No
Yes
25(10.9)
13(15.9)
1.1(0.4-3.3)
0.81
Glans Diameter
>13mm
≤13mm
21(12.9)
17(11.4)
Meatal Location
Distal
Midshaft/Proximal
22(9.3)
16(21.1)
1.5(0.5-4.1)
0.45
VC
≤30
>30
26(10.1)
12(22.1)