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11:08 - 11:11
S14-10
(PP)
FORESKIN RECONSTRUCTION VERSUS CIRCUMCISION IN DISTAL HYPOSPADIAS
Rajay RAMPERSAD, Yokelin NYO, John HUTSON, Mike O'BRIEN and Yves HELOURY
Royal Children's Hospital, Urology Department, Parkville, AUSTRALIA
PURPOSE
The goal of this study was to determine if there is an influence of the management of the foreskin (foreskin
reconstruction-FR or circumcision- CIRC) on the incidence of complications after surgical correction of distal hypospadias
.
MATERIAL AND METHODS
After approval by the local ethics committee, the data of distal hypospadias operated between 2005 and 2013 were
retrospectively reviewed. The inclusion criteria were coronal and sub-coronal hypospadias; no significant chordee
(<200) after degloving; urethroplasty by a TIP or Mathieu procedure. The exclusion criteria were: incomplete data;
glanular hypospadias; redo procedures; follow-up<1 year. The primary endpoint was the incidence of urethrocutaneous
fistula (UF). Secondary endpoints included reoperation rate and type of complications.
RESULTS
283 patients were included (127 FR and 156 CIRC). The 2 groups were comparable for age at surgery: 18.2 months in
FR and 15.1months in CIRC. The Mathieu were more common in FR (58/127-45.7% ) than in CiRC (56/156-35.9%). The
incidence of UF was 5.5% (7/217) in FR and 20.5% (32/156) in CIRC (p<0.01). The incidence of patients requiring
reoperation was 15.7% (20/127) in FR versus 35.9% (56/156) in CIRC (p<0.01). The total subsequent procedures
required were 27 in FR (9 catheterisations, 7 urethral fistula, 4 breakdowns, 1 abscess, 2 circumcisions, 3 preputial
fistulas, 1 preputioplasty) and 65 in CIRC (35 urethral fistula, 15 redo-urethoplasty, 6 catheterisations, 4 redo-
circumcisions, 2 scar releases, 2 dilatations, 1 haematoma).
CONCLUSIONS
In this study , the incidence of UF and the reoperation rate were significantly lower after FR.