ESPU Congress 2018 - Abstract Book

197 11–14 APRIL, 2018, HELSINKI, FINLAND MATERIAL AND METHODS For the technique, a 0.014 inch guide-wire is endoscopically inserted through the vesicoureteral junction (VUJ) and allowed to curl in the megaureter. A 4 or 5 mm atherotome-bladed cutting balloon (Cutting-Balloon ® ) is inflated in VUJ under fluoroscopy or cystoscopy control. Then, a 3 Fr JJ stent is placed for four weeks. RESULTS From January 2014 to January 2016, 21 patients were treated endoscopically for POM. In 3 patients (6 months to 3 years-old), balloon dilation was not possible, so it was performed endoureterotomy with Cutting-Balloon ® resulting in the immediate and complete disappearance of the stenosis. Hospital stay was 24 hours and intra or postoperative complications were not found. In evolution, urinary tract infections disappeared and ureterohydronephrosis improved in all cases. CONCLUSIONS Patients with POM can be treated endoscopically by high-pressure balloon dilatation. In case a persistent ring does not respond to balloon dilatation, endo-ureterotomy could provide a valid and safe definitive treatment of POM. VD-3 (VS without presentation) URETHRAL MOBILIZATION AND PARTIAL GLANDAR DISASSEMBLY: A STEP-BY-STEP VIDEO Antonio MACEDO JR  1 , Tassia LOBOUNTCHENKO  2 , Felipe DINI  2 , Sergio OTTONI  2 , Gilmar GARRONE  2 , Riberto LIGUORI  2 , Ricardo MARCONDES  2 and Marcela LEAL DA CRUZ  2 1) UNIFESP / NUPEP-CACAU-AACD, Pediatric Urology, São Paulo, BRAZIL - 2) NUPEP-CACAU-AACD, Pediatric Urology, São Paulo, BRAZIL PURPOSE We want to present in a step-by step video an alternative procedure for distal hypospadias consist- ing of urethral mobilization and partial glandar disassembly. MATERIAL AND METHODS A subcoronal circumcision was performed showing distal dysplasic urethra. The entire penis shaft was degloved and chordee tissue resected. Laterally to spongious tissue we incised the Buck's fas- cia on both sides releasing it from the corpora and created two glandar wings keeping however a small bridge of urethral plate to it. At this moment, the urethra advances cranially and both glandar wings can embrace the distal urethra with a more conical and physiological aspect of the glans. We sutured the urethra to the glans and finally performed the glans reconstruction. RESULTS Koff et al. published a modification of the Barcat technique known as extensive urethral mobilization and confirmed excellent cosmetic and functional results on 168 patients with only 3.5 % of the patients requiring reoperation. Mitchell & Blagi and Perovic et al. reported on complete penile disas- sembly for epispadia repair as a way to complete release of the rotation of the penis and treat dorsal chordee bringing the urethra to a more functional location. We were inspired by this procedure when we started doing extensive partial glandar disassembly in association with urethral mobilization. The rationale for this procedure is to avoid any suture, simply positioning the urethra distally without tension. The partial glandar disassembly teached us that it was possible to create a more conical and cosmetical glans. CONCLUSIONS We are convinced that this operation can be regarded as a genuine alternative to most cases of primary and redo distal hypospadias.