187 / 492
10:32 - 10:35
S14-3
(PP)
★
THE DUTCH HYPOSPADIAS STUDY: COMPLICATIONS AND PROGNOSTIC
FACTORS AFTER DISTAL- AND MID-TYPE HYPOSPADIAS REPAIR.
Fred VAN DER TOORN
1
, Keetje DE MOOIJ
2
, Rien NIJMAN
3
, Eric VAN DER HORST
4
, Piet CALLEWAERT
5
, Martijn
STEFFENS
6
, Piet HOEBEKE
7
, Marleen VAN DEN HEIJKANT
8
, Frank FROELING
9
, Mark WILDHAGEN
10
, Sten WILLEMSEN
11
,
Susan BRYAN
11
and Robert DE GIER
12
1) Sophia's Children Hospital, Pediatric Urology, Rotterdam, NETHERLANDS - 2) Pediatric Renal Center, University
Children's Hospital UMC, Pediatric Urology, Utrecht, NETHERLANDS - 3) University Medical Center Groningen, Pediatric
Urology, Groningen, NETHERLANDS - 4) VU University Medical Center Amsterdam, Pediatric Urology, Amsterdam,
NETHERLANDS - 5) Maastricht University Medical Center, Pediatric Urology, Maastricht, NETHERLANDS - 6) Isala
Hospital Zwolle, Pediatric Urology, Zwolle, NETHERLANDS - 7) University Hospital Gent, Pediatric Urology, Gent,
BELGIUM - 8) Universitätsklinik Vienna, Pediatric Urology, Vienna, AUSTRIA - 9) Haga Hospital The Hague, Pediatric
Urology, Den Haag, NETHERLANDS - 10) Erasmus Medical Center, Unit of Trials and Research Coördination, Rotterdam,
NETHERLANDS - 11) Erasmus MC, Biostatistics, Rotterdam, NETHERLANDS - 12) Radboud University Medical Center
Nijmegen, Pediatric Urology, Nijmegen, NETHERLANDS
PURPOSE
In 2009 our study group initiated a national prospective multicenter study to evaluate and possibly improve the
outcomes of hypospadias surgery. The aim of the current study is to evaluate the short term complications and
prognostic factors in the subgroup of mid- and distal type hypospadias.
MATERIAL AND METHODS
Data of the patient, disorder, surgical technique, pictures of cosmetic appearance and complications are prospectively
documented in a "web based" database. Complication rates, type complications, urethroplasty complications and
possible prognostic factors of the subgroup (sub)coronal, distal- and mid-shaft type hypospadias were evaluated six
months postoperatively. Annual reports inform the surgeons about their own results, mean outcomes of their
department and of the national study population.
In the near future, the surgical procedure(s) related to the prognostic factors and "best practices" will be recorded
anonymously and distributed on DVD enabling the participating surgeons to adapt their operative technique if
necessary.
RESULTS
In march 2015 a total of 1519 patients are enrolled in this national study, 1426 patients were surgically corrected of
whom 977 had a distal- or mid-type hypospadias of whom 781 can be evaluated six months postoperatively. Mean total
complication rate and urethroplasty complication rate were 23.3% and 16.4% respectively with a variation of 9%-75%
and 4%-63% between the surgeons. Preliminary multvariate analysis identified optical magnification and subepithelial
urethroplasty suture technique as prognostic factors for a lower complication rate.
CONCLUSIONS
Our national hypospadias study demonstrates a wide variation in complication rates between the surgeons. These
complication outcomes may improve by reporting surgical details of prognostic factors and "best practices".