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

11:02 - 11:05

S14-8

(PP)

EXPERIENCE WITH THE USE OF ACELLULAR MATRICES (ACMS) IN COMPLEX

URETHROPLASTY.

Anna RADFORD

, Alexander SPRINGER

and Ramnath SUBRAMANIAM

1) Leeds Teaching Hospitals NHS Trust, Department of Paediatric Urology and Surgery, Leeds, UNITED KINGDOM - 2)

Medical University of Vienna, Department of Pediatric Surgery, Vienna, AUSTRIA

PURPOSE

Management of complex hypospadias and related complications remains challenging, with complication rates reported at

39.7% (Castagnetti et al. J.Urol.2010; 184, 1469-1475). Many complications arise due to lack of good quality tissue at

the repair site. We have utilised a cross-linked ACM to support the tissues in difficult urethroplasty cases and here we

report our outcomes.

MATERIAL AND METHODS

From 2008 to 2014, in a tertiary centre, 24 boys (median age 5.34 years) underwent urethral reconstruction utilising

Pelvicol® as a periurethral splint. Surgical indications included: complex hypospadias, urethral fistulae, redo-

urethroplasty and urethral diverticulum. Outcome data was collected prospectively, independent from the surgeon and

included complications, uroflowmetry and parental perception.

RESULTS

All 24 boys made a good recovery. Median follow-up was 1.84 years (range 3 months – 3.8 years). One child, at four

months, required removal of the graft for late infection; another case reported skin tethering. Uroflowmetry was

performed in 17/24 (70.8%) boys. QMax (r= 0.56, p= 0.018) and average flow (r=0.52, p =0.03), which correlated

with age. Parental satisfaction with outcome was reported as excellent in 11 boys (64.7%), good in 4 (23.5%),

satisfactory in 1 (5.9%) and poor in 1 (5.9%).

CONCLUSIONS

These results support the use of periurethral Pelvicol® in primary second stage and redo-hypospadias surgery. A long-

term study will be required to support these findings. Ongoing animal studies will help identify the most suitable

biomaterial for the support of urethra repairs and may open further opportunities for progress in reconstructive urology.