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96
29
th
CONGRESS OF THE ESPU
16:20–16:25
S11-4 (LO)
★
A NEW OBJECTIVE SCORING SYSTEM FOR
THE PREDICTION OF COMPLICATIONS AFTER
HYPOSPADIAS SURGERY
Halil TUGTEPE
1
, David Terence THOMAS
2
, Zeynep CALIKLI
3
, Arzu CANMEMIS
1
,
Raziye ERGUN
1
, Nicat VALIYEV
4
and Tolga DAGLI
1
1) Marmara University School of Medicine, Department of Pediatric Surgery, Division of Pediatric Urology, Istanbul,
TURKEY - 2) Maltepe University Faculty of Medicine, Department of Pediatric Surgery, Istanbul, TURKEY - 3) Marmara
University School of Medicine, Department of Pediatric Surgery, Surgical Nurse, Istanbul, TURKEY - 4) Marmara
University School of Medicine, Department of Pediatric Surgery, Istanbul, TURKEY
PURPOSE
Despite several studies, there is no universally accepted scoring system that predicts the develop-
ment of complications of hypospadias surgery, based on preoperative factors. The aim of this study
is to develop a new objective scoring system to predict the development of complications after
hypospadias surgery.
MATERIAL AND METHODS
The scoring system included glans diameter, groove, plate and meatal location plus the presence of
chordee. For each factor, points of 1–3 (glans diameter, groove and plate) or 1–4 (meatal location
or chordee) were scored (total between 5–17). Patients who underwent surgery for hypospa-
dias between May 2011 and January 2017 with a minimum of 3-month follow-up were included.
Prospectively collected data was analysed retrospectively. Patients undergoing two session repair
were not included. Patients’ scores were compared with complications using ROC curves. The
appropriate cut-off value was calculated using the Youden method.
RESULTS
Five hundred and twenty-three patients (average age: 42.0±33.7 m, average follow-up: 39.6±23.4 m)
were included. Complications were observed in 51 (9.8 %) patients. The cut-off value for optimal
prediction of complications was determined as 10 with a negative predictive value of 93.9 %. The
complication rate of patients who had 10 or fewer points was 7.4 % (n=32/430), the complication
rate for those with 11 or more points was 20.4 % (n=19/93) (p=0.0001).
CONCLUSIONS
This new objective scoring system was found to successfully predict complications after hypospa-
dias surgery. Patients with scores of 11 and above have statistically significantly more complications.
We believe this new objective scoring system will be a guide surgeons who perform hypospadias
surgery.