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DISTENSIBILITY OF THE URETHRA WITH FUNCTIONAL
LUMEN IMAGING PROBE (FLIP™) IN THE INTRAOPERATIVE
ASSESSMENT OF HYPOSPADIAS: DOES BIOMECHANICS
SUPPORT THE SURGICAL DECISION MAKING?
Ida FAURSCHOU
1
, Andreas ERNST
2
, Jingbo ZHAO
3
, Donghua LIAO
3
,
Jens Christian DJUURHUS
1
and L. Henning OLSEN
4
1) Aarhus University, Department of Clinical Medicine, Aarhus N, DENMARK - 2) Aarhus University, Department
of Public Health, Section for Epidemiology, Aarhus C, DENMARK - 3) Aarhus University, Giome Academia, Department
of Clinical Medicine, Aarhus N, DENMARK - 4) Aarhus University Hospital, Department of Urology, Section for Peadiatric
Urology, Aarhus N, DENMARK
PURPOSE
Hypospadias can be accompanied by alterations in urethral biomechanics which may lead to
hampered voiding. Even before repair compliance in urethra may be different. Today assessment of
urethral size and tissue quality rely on observer-dependent inspection and simple calibration sticks.
This study concerns development of a method to assess urethral size and biomechanical properties
specifically to compare normal urethras with hypospadias before surgery.
MATERIAL AND METHODS
Modified measurements of electrical impedance using the Functional Lumen Imaging probe (FLIP)
was used to assess compliance in the urethra under two steps pressure rise (0-40-60 cmH2O) in
a bag covering the impedance measuring system. 15 boys with varying degrees of hypospadias
were compared to 4 controls in a non-blinded prospective clinical observational study.
RESULTS
Mean age was 15.3 months for hypospadias and 10.7 months for controls. Our preliminary results
show that the urethra of boys with hypospadias have a functional narrowing of the urethral lu-
men. Our analysis further suggests that patients with hypospadias have a less compliant urethra.
Comparison of visual imaging shows a different shape of urethra in hypospadias patients.
We continue to include patients and controls.
CONCLUSIONS
The study is the first to use functional lumen imaging of the urethra in patients with hypospadias. It
might help to understand the structural and functional changes associated with hypospadias.
The FLIP method is feasible and may be a future way of assessing urethral biomechanics aiding the
surgical strategy in hypospadias and in addition potentially be included in postoperative assessment
when needed.