ESPU Congress 2018 - Abstract Book

CONGRESS OF THE ESPU

12:03–12:06

S8-5 (PP)

LONG-TERM FOLLOW-UP OF ADOLESCENTS OPERATED

FOR PROXIMAL HYPOSPADIAS; DO UROLOGICAL

RESULTS DIFFER COMPARING 3 SURGICAL TECHNIQUES?

Marie ANDERSSON

, Monika DOROSZKIEWICZ

, Sofia SJÖSTRÖM

and

Gundela HOLMDAHL

1) The Sahlgrenska Academy, Department of Pediatric Urology, Queen Silvia's Children's Hospital, Sahlgrenska

University Hospital, Gothenburg, SWEDEN - 2) The Pediatric Uro-Nephrologic Centre, Department of Pediatric Urology,

Queen Silvia's Children's Hospital, Sahlgrenska University Hospital, Gothenburg, SWEDEN

PURPOSE

Surgery for proximal hypospadias is challenging and entails risk of complications. The primary aim

of this prospective cohort study was to reinvestigate adolescents operated for proximal hypospadias

in childhood with three different techniques, Tubularized Incised Plate (TIP), vascularized graft as

Onlay or tubularized (Duckett), comparing urological outcome and complication rates.

MATERIAL AND METHODS

57 adolescents ≥ 14 years of age operated for proximal hypospadias (penoscrotal to perineal)

between 1996–2005 and followed at a single center were identified. 40 accepted participation with

a clinical assessment, at Md 16.5 years (14–25), including voiding history, genital examination

and uroflowmetry. Results were matched with data from charts regarding operations and previous

urinary flow.

RESULTS

30 penoscrotal and 10 scrotal/perineal hypospadias were operated with TIP (N=14), Onlay (N=14),

Duckett (N=11) and chordee-correction only (N=1). Curvature correction was performed with plica-

tion (N=12) and rotation of corpora (N=4).

Nineteen patients (48 %) had one surgical event, but 29 % (4/14) of TIP, 50 % (7/14) of Onlay and

82 % (9/11) of Duckett required reinterventions (p=0.0062). TIP patients had longer penile length

(Md 9.4 cm; 7.5–11.0) than Onlay (8.0 cm; 4.0–11.0) and Duckett (8.0 cm;5.0–10.0) (p=0.016,

p=0.045) but more curvature at puberty than Duckett (p=0.0062). There was no difference in glanu-

lar sensibility comparing different methods of urethroplasty, nor comparing number of reoperations

neither different curvature correction procedures. Maxflow at puberty was Md 12.4 ml/s (2.5–47.3).

Impaired flows (≤10 ml/s) were found in 3/14 of TIP, 1/14 of Onlay and 1/11 of Duckett (ns). There

was significant improvement in all groups compared to maxflows at five years of age.

CONCLUSIONS

This study showed that Duckett required significantly more reoperations than TIP but TIP, with

preservation of the urethral plate, had more curvature at puberty. Uroflowmetry results were accept-

able and comparable between groups.

12:06–12:15

Discussion