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

S12-17

(P)

SHOULD WE CHANGE THE INDICATIONS OF HORMONAL INVESTIGATIONS FOR

NEWBORN WITH HYPOSPADIAS?

Elodie HARAUX

, Camille DEVAUCHELLE

, Xavier DELFORGE

, Karen CHARDON

and Karine BRAUN

1) University Hospital, Pediatric surgery, Amiens Cedex 1, FRANCE - 2) University hospital, Pediatric unit, Amiens Cedex

1, FRANCE - 3) PERITOX-INERIS EA 4285, Jules Vernes Picardy University, Amiens Cedex 1, FRANCE

PURPOSE

The indications for hormonal investigations in neonatal hypospadias are not subject to validated recommendations.

Testing is typically limited to cases with severe hypospadias,or if associated with a micropenis, an undescended testicle

(UDT), bifid scrotum, family history or syndromic form.

MATERIAL AND METHODS

We report a prospective study about 39 newborns with hypospadias (30 distal,6 middle, 3 proximal). Hormone assays

were performed before 24 hours of life (FSH, LH, testosterone, 17OHprogestérone) and at 6 weeks of age (FSH, LH,

testosterone, AMH). An hCG test and an androgen receptor mutation (AR) research have been performed in case of

abnormality. One case had a syndromic form, 3 UDT, 3 family history of hypospadias. None had scrotal abnormalities or

micropenis.

RESULTS

Twenty-eight were considered to have normal hormonal profiles. Among the 11 abnormal, 9 hCG tests were performed

(2 lost to follow), 4 of which (10.25%) were abnormal (1 middle, 1 posterior and 1distal hypospadias at monozygotic

twins) with a AR mutation. Fourteen tests would have been indicated by the conventional indications. A non indicated

test (isolated distal hypospadias) was abnormal with normal complementary hCG test.

CONCLUSIONS

No hormonal profiles done in cases of isolated or distal hypospadias were abnormal. We have one case of twins with

isolated distal hypospadias and a AR mutation. In the situation where both twins have hypospadias, even if distal and

isolated, this should be considered a family history and indicate neonatal hormonal investigations. From these data and

the literature, we propose to follow the current guidance. The recommendations edition would harmonize pratices.