154 / 330
154
28
TH
CONGRESS OF THE ESPU
RESULTS
152 patients with an average age of 41.3±31.7 (median 27.5) months were included in the study.
Meatus locations was subcoronal in 40.8% (n=62), coronal in 42.8% (n=65) and midshaft in 16.4%
(n=25). Average followup was 47±8.0 months. Complications were observed in 17.1% (n=26)
pateints (17 fistula, 7 meatal stenosis, 1 glans opening, 1 glans closure). Penile length measure-
ments were similar in those with or without complications. Complication rates were not different in
pateints with glans diameter above 14mm vs below 14mm (p>0.05).
CONCLUSIONS
This study has demonstrated that penile measurement taken during surgery for hypospadias do not
correlate with complication rates.
S14-9 (P without presentation)
CHALLENGING THE 2 STAGE DOGMA IN SCROTAL /
PERINEAL HYPOSPADIAS- 15 YEAR EXPERIENCE
Devesh MISRA
1
, Anastasia VARELI
1
, Ashwini JOSHI
1
, Clare SKERRITT
1
and Shazia SHARIF
2
1) Royal London Hospital, Paediatric Urology, London, UNITED KINGDOM - 2) Royal London hospital, Dept
of Paediatric Urology, London, UNITED KINGDOM
PURPOSE
Medical literature has very few papers published on complication rates in ‘pure’ scrotal hypospadias
surgery. We analysed our experience over 15 years, making this one of the largest series reported
on this subject.
MATERIAL AND METHODS
This is a prospective series -every patient undergoing hypospadias was logged into a database. We
found 92 patients with scrotal or perineal hypospadias, 85% of whom were operated by the senior
surgeon.
56 had a single stage procedure, including 15 who had a buccal mucosa ‘Snodgraft’. 36 had
a staged Bracka procedure : 19 buccal, 17 prepucial grafts. The median number of procedures per
patient was 2 (range from 1 to 9, including dilations).
Total number of patients who had a buccal graft -34.
The median follow up- 4.5 years (6 to 172 months).
RESULTS
Our complication rate was as follows-
Urethral fistula: 26 (28%).
Stenosis: 25 (27%).
Wound breakdown: 6 (6.5%).
Graft failure: 1 (1%).
The fistula rate in Bracka staged operations was 30% and in one-stage procedure was 26%.
Testosterone therapy was given to 23 boys and 13 saw a significant increase in penile size.
However, 3 patients developed pubic hair transiently.
CONCLUSIONS
Scrotal hypospadias remains a challenging condition to treat.
1. It is possible to do a single stage repair in 60%. This brings down the median number of opera-
tions to only 2.
2. We succesfully used buccal or lower lip grafts in 37%. This allowed us to preserve the dorsal
hood or foreskin for covering the penile shaft, or for later use in case of redo- surgery.
3. A quarter of our patients needed testosterone and over half had a pleasing increase in size of the
phallus.