ESPU Congress 2018 - Abstract Book

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94 29th CONGRESS OF THE ESPU
16:03–16:08
S11-2 (LO)
★ HYPOSPADIAS OBJECTIVE PENILE EVALUATION (HOPE)
SCORE AFTER DISTAL- AND MID-TYPE HYPOSPADIAS
REPAIR IN THE DUTCH HYPOSPADIAS STUDY
Fred VAN DER TOORN1, Barbara KORTMANN2, Piet CALLEWAERT3 , Piet
HOEBEKE4 , Eric VAN DER HORST5 , Martijn STEFFENS6 , Frank FROELING7, Keetje
DE MOOIJ8 , Rien NIJMAN9 , Mark WILDHAGEN10, Sten WILLEMSEN11 and Marleen
VAN DEN HEIJKANT12
1) Sophia Children's Hospital, Paediatric Urology, Rotterdam, NETHERLANDS - 2) Radboud University Medical Center
Nijmegen, Pediatric Urology, Nijmegen, NETHERLANDS - 3) Maastricht University Medical Center, Pediatric Urology,
Maastricht, NETHERLANDS - 4) University Hospital Gent, Pediatric Urology, Gent, BELGIUM - 5) VU University Medical
Center Amsterdam, Pediatric Urology, Amsterdam, NETHERLANDS - 6) Isala Hospital Zwolle, Pediatric Urology, Zwolle,
NETHERLANDS - 7) Haga Hospital The Hague, Pediatric Urology, The Hague, NETHERLANDS - 8) Pediatric Renal
Center, University Children's Hospital UMC, Pediatric Urology, Utrecht, NETHERLANDS - 9) University Medical Center
Groningen, Pediatric Urology, Groningen, NETHERLANDS - 10) Erasmus Medical Center Rotterdam, Unit of Trials and
Research Coördination, Rotterdam, NETHERLANDS - 11) Erasmus Medical Center Rotterdam, Biostatistics, Rotterdam,
NETHERLANDS - 12) University Hospital Leuven, Pediatric Urology, Leuven, BELGIUM
PURPOSE
Creation of a normal anatomic appearance is an important goal in hypospadias surgery. Our
Hypospadias Objective Penile Evaluation (HOPE)-score is a validated objective outcome measure
which incorporates all surgically correctable items: meatal position, meatal shape, glans shape, skin
shape and penile axis. Aim of current study is to determine appearance outcomes in the subgroup
of (sub)coronal, distal- and mid-shaft hypospadias.
MATERIAL AND METHODS
In our national prospective multicenter study a professional panel independently assessed
standardized anonymized pictures before and 6 months after surgery using the HOPE-score. This
HOPE(item)-score ranges from 1 (minimum) to 10 (maximum). The HOPE-score improvement was
calculated as the difference between the mean post- and pre-operative HOPE-score.
RESULTS
Sufficient photographic quality in this subgroup was available in 706 patients pre-operatively,
437 post-operatively and in 347 patients at both time points.
In the preputial excision (PE) and preputial reconstruction (PR)-group the total HOPE-score im-
provement was (PE/PR) TIP 2.72/2.68, MAGPI 1.62/1.82, Urethral Advancement (UA) 1.40/1.41,
modified-Mathieu (MM) 1.51/1.18 and Duckett-Onlay (DO) 1.91/-. In both PE- and PR-groups the
highest score improvement of 3.3 points was achieved by surgeons using TIP.
The HOPE-item score improvement for meatal position (PE/PR) was TIP 3.09/2.92, MAGPI
1.30/1.62, UA 1.83/1.51, MM 2.04/1.62, DO 3.25/-, meatal shape TIP 2.5/2.13, MAGPI 0.53/0.67,
UA 0.67/-0.42, MM -0.07/-1.0, DO 1.13/-, glans shape TIP 3.17/2.75, MAGPI 1.76/1.14, UA
1.17/0.69, MM1.0/1.07, DO 2.0/- and shape skin TIP 4.41/5.71, MAGPI 4.26/5.82, UA 3.5/6.8, MM
5.5/6.4, DO 4.13/-.
CONCLUSIONS
In our study the HOPE-score identifies TIP as technique with the best appearance outcomes for
especially meatal shape and glans shape. This HOPE-score can also indicate aspects of the opera-
tive procedure that need critical attention and can help to initiate a cycle for improvement in striving
to create a normal anatomic appearance for our hypospadias patients.