MP47-15 DO NEW COMPLICATIONS DEVELOP DURING PUBERTY AFTER CHILDHOOD HYPOSPADIAS REPAIR?

Abstract

You have accessJournal of UrologyPediatric Urology III (MP47)1 Sep 2021MP47-15 DO NEW COMPLICATIONS DEVELOP DURING PUBERTY AFTER CHILDHOOD HYPOSPADIAS REPAIR? Warren Snodgrass, and Nicol Bush Warren SnodgrassWarren Snodgrass More articles by this author , and Nicol BushNicol Bush More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002068.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: It has been hypothesized that pubertal growth might cause new hypospadias complications after successful childhood repair, with a few reports describing new fistulas, ventral curvature and strictures. Worry that repairs are not durable can influence parent decision-making and recommended follow up. We treat hypospadias patients of all ages, potentially offering a different perspective on long-term results than those reported from practices limited to either pediatric or adult patients. Accordingly, we reviewed teens and adults presenting with hypospadias complications to determine when they developed. METHODS: We reviewed our prospective database to identify all Tanner stage 2-5 patients presenting from 2015 - 2020 with complications following childhood hypospadias repair, including fistulas, glans/wound dehiscence, recurrent ventral curvature, meatal stenosis and urethral stricture. Onset of symptoms and findings were categorized as occurring at Tanner stages 1, 2-4, and 5 to indicate before, during and after puberty. RESULTS: A total of 77 patients included 16 Tanner 2-4 and 61 Tanner 5 patients, mean ages 13 (12-17) and 33 (15-66) years. 31% had distal and 69% proximal hypospadias. Initial repairs were done before age 5 in 97%. Main complaints included urine spraying (64%), unsatisfactory appearance (26%) obstructive voiding (22%) and UTI (14%). Complications included dehiscence (71%), ventral curvature which averaged 50° (42%), strictures (22%), fistulas (18%) and meatal stenosis (6%). Most (83%) complications, including all dehiscence and ventral curvature, were present before puberty. No new complications developed during puberty (Tanner 2-4). Only 2/77 (3%) patients had a new, non-obstructive complication after puberty, both fistulas. 11 (14%) developed new obstructive voiding symptoms at mean age 36 years from strictures (9) or meatal stenosis (2). CONCLUSIONS: Our series found no new complications attributed to pubertal growth. Rather, like Barbagli et al (2006), we found teens and adults with complications after childhood hypospadias repair presented in 2 groups. Most had persistent problems still not corrected. Fewer presented with new problems, mostly obstruction from strictures and meatal stenosis which became symptomatic at an average of 30+ years after their initial prepubertal repair. This information can help surgeons advise parents regarding outcomes of childhood surgery and determine the length of follow up. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e829-e829 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Warren Snodgrass More articles by this author Nicol Bush More articles by this author Expand All Advertisement Loading ...