ESPU Congress 2018 - Abstract Book

93 11–14 APRIL, 2018, HELSINKI, FINLAND S11: HYPOSPADIAS 2 Moderators: Luis Braga (Canada), Mehmet Eliçevik (Turkey) ESPU Meeting on Thursday 12, April 2018, 16:00–16:34 16:00–16:03 S11-1 (PP) ★ DOES THE ANOGENITAL DISTANCE PREDICT OUTCOME OF HYPOSPADIAS REPAIR? Ursula TONNHOFER  1 , Manuela HIESS  2 , Martin METZELDER  1 , Doris HEBENSTREIT  3 , Christoph KRALL  4 and Alexander SPRINGER  5 1) Medical University Vienna, Pediatric Surgery, Vienna, AUSTRIA - 2) Medical University Vienna, Department of Urology, Vienna, AUSTRIA - 3) Wilhelminenspital der Stadt Wien, Department of Urology, Vienna, AUSTRIA - 4) Medical University Vienna, Department of Statistics, Vienna, AUSTRIA - 5) Medical university Vienna, Paediatric Urology, Vienna, AUSTRIA PURPOSE The anogenital distance (AGD) is androgen action dependent. It is sexually dimorphic and seems to be shorter in androgen-action related diseases like hypospadias. In this study we sought to determine whether the anogential distance is predictive for surgical outcome of hypospadias repair. MATERIAL AND METHODS Patients were collected prospectively. AGD was measured in OR prior to surgery by 2 surgeons (blinded, each 3 times). Outcome parameters were definded as: 1.) complications (fistula, breakdown, glans dehiscence) and 2.) need for staged repair. There were 186 prepubertal boys: 119 controls 2.38yrs (0.02–10.2) and 67 hypospadias (45 distal hypospadias 2.89yrs (0.07–9.67) and 22 proximal hypospadias 2.66yrs (0.58–9.76). Mean follow- up was 1.5yrs. RESULTS There was no difference in AGD in controls and mild hypospadias. Severe hypospadias had a sig- nificantly shorter AGD (p=0.003). AGD was significantly shorter in patients undergoing staged repair (36 mm vs. 27 mm, p=0.001). AGD was significantly shorter in patients who developed postopera- tive complications (38 mm vs. 30 mm, p=0.04). CONCLUSIONS The AGD seems to have predictive value regarding outcome of hypospadias repair. Hypothetically, a short AGD resembles impaired intra uterine androgen action (low androgens, androgen receptor problems, counteracting endocrine disruptors, and unknown genetic androgen interaction). These fetal androgen problems may be reflected in hypospadias minor tissue quality resulting in delayed wound healing, inflammation and a higher complication rate or more difficult surgery resulting in staged repair.