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S14-17
(P)
A COMPARISON OF THE FUNCTIONAL OUTCOMES AFTER HYPOSPADIAS REPAIR
IRRESPECTIVE OF COMPLEXITY.
Milan GOPAL, Anna RADFORD and Ramnath SUBRAMANIAM
Leeds Teaching Hospitals NHS Trust, Department of Paediatric Urology and Surgery, Leeds, UNITED KINGDOM
PURPOSE
To compare the functional outcomes after hypospadias repair irrespective of original complexity.
MATERIAL AND METHODS
Sixty-seven consecutive uroflow assessments, done after hypospadias repair performed by a single surgeon, were
collected and divided into two groups based on the complexity of the original hypospadias. Group A: Primary distal
hypospadias; (n=35) and Group B: complex hypospadias (primary proximal hypospadias repair and redo urethroplasties
) (n=32). Functional assessment for the entire cohort was done at a median of two years after surgery (6 months-8
years). Qmax, average flow rate, voided volume, post-void residual and uroflow-curve analysis were assessed and
compared to nomograms. Mann Whitney U or Wilcoxon-matched pairs test and unpaired t-test were used for statistical
analysis.
RESULTS
The median age at surgery for Group A and B was 2 yrs (1-13 ) and 4 yrs (2-15) respectively. The median age at
uroflow assessment was 4yrs (3-14 ) in Group A and 6.5yrs ( 3-16 ) in Group B. Uroflow rates correlated with age. No
significant difference in Qmax or average flow rate existed between the groups, despite significant differences in age
(p=0.001) and voided volume (p=0.007). Both Qmax and average flow rates in both the groups were significantly
lower than matched values from nomograms. All the boys in Group B were asymptomatic. Two of the children in Group
A reported frequency and nocturnal enuresis.
CONCLUSIONS
There was no significant difference in the uroflow rates between the distal and complex groups. Uroflow rates after
hypospadias repair were significantly lower than controls despite the majority being asymptomatic. New nomograms for
hypospadias may identify outliers at risk of future problems.