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S12-7
(PP)
DISTAL HYPOSPADIAS REPAIR: COMPARATIVE UROFLOWMETRY, WHAT IS
NORMAL?
Anna RADFORD
1
, Anne-Francoise SPINOIT
2
, Junaid ASHRAF
1
, Milan GOPAL
1
and Ramnath SUBRAMANIAM
1
1) Leeds Teaching Hospitals NHS Trust, Department of Paediatric Urology and Surgery, Leeds, UNITED KINGDOM - 2)
Gent University Hospital, Department of Urology, Gent, BELGIUM
PURPOSE
Uroflowmetry is recommended for functional assessment after hypospadias repair. This consecutive series reports
prospective uroflowmetry of distal hypospadias primary repairs (DHPR) and compares these to age and voided-volume
matched controls from two published nomograms.
MATERIAL AND METHODS
A retrospective database of patients undergoing DHPR was created. Patients were invited for prospective functional
uroflowmetry. Exclusions included: age < 2years or >13years and incomplete uroflow assessments. Maximum flowrate
(QMax), average flowrate (AFR) and voiding time (VT) were compared to nomograms; Gutierrez-Segura et al. J.Urol
1997; 157,1426-1428 and Szabo et al. BJU 1995;76,16-20. Descriptive and non-parametric statistical analysis were
performed.
RESULTS
Between 30/09/2011- 1/04/2014 112 patients underwent DHPR were operated on. After exclusions, 51 patients were
eligible. Median age at surgery was 24.0 months [14-132]; median follow-up 22 months [6-48]. Bell-shaped uroflow
curves were obtained in 48/51 at median of 4.0 [3.0-14.0] years old. Median QMax was 10 ml/s [4-24], matched
median QMax from two nomograms, were 15.2ml/s [10-27.5] and 17ml/s [9-29] significantly different to the study
cohort (p=< 0.001). Median AFR and median VT were 4.0ml/s [1-9] and 21s [9-58] respectively, significantly different
to matched controls; 8.8 [6-15.5] and 8.8 [6-16] (p=<0.001).
CONCLUSIONS
In our series, asymptomatic boys post distal hypospadias repair, had significantly different uroflowmetry results
compared to nomograms in healthy populations. Uroflowmetry is an important follow-up tool, however further
information is required to improve interpretation of uroflow results in order to accurately evaluate surgical outcomes and
determine “normality” in the hypospadias-repaired population.