ESPU Congress 2018 - Abstract Book
80 29 th 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 1 , Monika DOROSZKIEWICZ 2 , Sofia SJÖSTRÖM 1 and Gundela HOLMDAHL 1 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
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