Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

08:42 - 08:45

S12-10

(PP)

NORMALIZED URINARY FLOW AT PUBERTY AFTER TIPU REPAIR OF

HYPOSPADIAS IN CHILDHOOD

Marie ANDERSSON

, Monika DOROSZKIEWICZ

, Charlotte ARFWIDSSON

, Kate ABRAHAMSSON

, Ulla SILLÉN

and

Gundela HOLMDAHL

1) Queen Silvia's Children's hospital, Pediatric urology, Queen Silvia's Children's hospital, Gothenburg, SWEDEN - 2) The

Pediatric Uro-Nephrologic Center, Pediatric urology, Queen Silvia's Children's hospital, Gothenburg, SWEDEN

PURPOSE

An obstructive urinary flow pattern is frequently seen after tubularized incised plate urethroplasty (TIPU) for

hypospadias.

Our aim was to describe the results after puberty.

MATERIAL AND METHODS

126 boys underwent surgery using TIPU for distal penile to midshaft hypospadias between 1999-2003. Toilet-trained

boys at the time of surgery (n=48) were included in a first study. The same cohort was followed after seven years and

at puberty (n=40, median age 15.0 years; 13.7-17.1).

Clinical examination, urinary medical history, uroflowmetry and ultrasound for measuring residual urine were performed.

Hypospadias Objective Scoring Evaluation (HOSE) was used in addition for outcome evaluation. Maximum urinary flow

was correlated to age and voided volume using nomograms by Miskolc for comparison in percentiles.

RESULTS

One year after surgery, 37.5% of the boys had a normal urinary flow (more than or equal to 25th percentile) compared

with 40% after seven years and 95% at puberty (p<0.0001). Maximum flow was a median of 11 ml/s (6-25ml/s) after

one year, 15 ml/s (5-36ml/s) after seven years and 26 ml/s (11-56ml/s) at puberty. A normal urinary stream was found

in 82% and residual urine in 5% (two boys). At puberty, one persistent coronal urethral fistula (glandular membrane),

one corrected former urethral fistula and four preputial fistulas (of 23 preputioplasties) were noted. During the follow-up

time, five patients underwent a meatotomy due to obstructive symptoms and four were dilated. Three of these nine had

lichen sclerosus (LS). All of the interventions, except one, occurred before the 7-year follow-up.

Eighty-five percent had a HOSE score equal to or more than 14. Three boys (7,5 %) described a slight curvature during

erection.

CONCLUSIONS

There is great potential for the normalization of urinary flow at puberty for boys treated for hypospadias with TIPU

repair.