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Normalized Urinary Flow at Puberty after Tubularized Incised Plate Urethroplasty for Hypospadias in Childhood

2015; Lippincott Williams & Wilkins; Volume: 194; Issue: 5 Linguagem: Inglês

10.1016/j.juro.2015.06.072

1527-3792

Marie Andersson, Monika Doroszkiewicz, Charlotte Arfwidsson, Kate Abrahamsson, Ulla Sillén, Gundela Holmdahl,

Urologic and reproductive health conditions

No AccessJournal of UrologyPediatric Urology1 Nov 2015Normalized Urinary Flow at Puberty after Tubularized Incised Plate Urethroplasty for Hypospadias in Childhood Marie Andersson, Monika Doroszkiewicz, Charlotte Arfwidsson, Kate Abrahamsson, Ulla Sillén, and Gundela Holmdahl Marie AnderssonMarie Andersson , Monika DoroszkiewiczMonika Doroszkiewicz , Charlotte ArfwidssonCharlotte Arfwidsson , Kate AbrahamssonKate Abrahamsson , Ulla SillénUlla Sillén , and Gundela HolmdahlGundela Holmdahl View All Author Informationhttps://doi.org/10.1016/j.juro.2015.06.072AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: An obstructive urinary flow pattern is frequently seen after tubularized incised plate urethroplasty for hypospadias. However, the significance of this finding has not been determined and long-term results are few. We describe postoperative long-term uroflowmetry results after puberty in males who underwent tubularized incised plate urethroplasty in childhood. Materials and Methods: A total of 126 boys underwent tubularized incised plate urethroplasty for distal penile to mid shaft hypospadias at Queen Silvia Children's Hospital in Gothenburg between 1999 and 2003. Of the patients 48 were toilet trained at surgery. We report on 40 patients who had data available at 2 and 12 months postoperatively, 7 years postoperatively and at puberty (median age 15.0 years, range 13.7 to 17.1). Of the patients 31 had distal and 9 had mid penile hypospadias. Clinical examination, urinary medical history, uroflowmetry and ultrasound measuring residual urine were performed. Maximum urinary flow was correlated to age and voided volume, using Miskolc nomograms for comparison of percentiles. Results: At 1 year postoperatively 15 boys (37.5%) had normal urinary flow (above 25th percentile), compared to 16 (40%) at 7 years and 38 (95%) at puberty (p <0.0001). Improvement was significant in patients with distal (p <0.0001) and mid penile hypospadias (p = 0.008), as well as in patients who did (p = 0.0078) and did not undergo intervention (p <0.0001). During followup 5 patients underwent meatotomy due to obstructive symptoms and 4 underwent dilation. Three of these 9 patients had lichen sclerosus. Conclusions: There is great potential for normalization of urinary flow at puberty for boys with hypospadias treated with tubularized incised plate urethroplasty. Unless symptoms occur, a conservative approach seems preferable. References 1 : Population based nationwide study of hypospadias in Sweden, 1973 to 2009: incidence and risk factors. J Urol2014; 191: 783. Link, Google Scholar 2 : Snodgrass technique for hypospadias repair. BJU Int2005; 95: 683. 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Volume 194Issue 5November 2015Page: 1407-1413 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordshypospadiasfollow-up studiesurethral obstructionpubertyurinationMetricsAuthor Information Marie Andersson More articles by this author Monika Doroszkiewicz More articles by this author Charlotte Arfwidsson More articles by this author Kate Abrahamsson More articles by this author Ulla Sillén More articles by this author Gundela Holmdahl More articles by this author Expand All Advertisement PDF downloadLoading ...