ESPU Congress 2018 - Abstract Book

11–14 APRIL, 2018, HELSINKI, FINLAND

S11: HYPOSPADIAS 2

Moderators: Luis Braga (Canada), Mehmet Eliçevik (Turkey)

ESPU Meeting on Thursday 12, April 2018, 16:00–16:34

16:00–16:03

S11-1 (PP)

★

DOES THE ANOGENITAL DISTANCE PREDICT OUTCOME

OF HYPOSPADIAS REPAIR?

Ursula TONNHOFER

, Manuela HIESS

, Martin METZELDER

Doris HEBENSTREIT

, Christoph KRALL

and Alexander SPRINGER

1) Medical University Vienna, Pediatric Surgery, Vienna, AUSTRIA - 2) Medical University Vienna, Department

of Urology, Vienna, AUSTRIA - 3) Wilhelminenspital der Stadt Wien, Department of Urology, Vienna, AUSTRIA -

4) Medical University Vienna, Department of Statistics, Vienna, AUSTRIA - 5) Medical university Vienna, Paediatric

Urology, Vienna, AUSTRIA

PURPOSE

The anogenital distance (AGD) is androgen action dependent. It is sexually dimorphic and seems

to be shorter in androgen-action related diseases like hypospadias. In this study we sought to

determine whether the anogential distance is predictive for surgical outcome of hypospadias repair.

MATERIAL AND METHODS

Patients were collected prospectively. AGD was measured in OR prior to surgery by 2 surgeons

(blinded, each 3 times). Outcome parameters were definded as: 1.) complications (fistula,

breakdown, glans dehiscence) and 2.) need for staged repair. There were 186 prepubertal boys:

119 controls 2.38yrs (0.02–10.2) and 67 hypospadias (45 distal hypospadias 2.89yrs (0.07–9.67)

and 22 proximal hypospadias 2.66yrs (0.58–9.76). Mean follow- up was 1.5yrs.

RESULTS

There was no difference in AGD in controls and mild hypospadias. Severe hypospadias had a sig-

nificantly shorter AGD (p=0.003). AGD was significantly shorter in patients undergoing staged repair

(36 mm vs. 27 mm, p=0.001). AGD was significantly shorter in patients who developed postopera-

tive complications (38 mm vs. 30 mm, p=0.04).

CONCLUSIONS

The AGD seems to have predictive value regarding outcome of hypospadias repair. Hypothetically,

a short AGD resembles impaired intra uterine androgen action (low androgens, androgen receptor

problems, counteracting endocrine disruptors, and unknown genetic androgen interaction). These

fetal androgen problems may be reflected in hypospadias minor tissue quality resulting in delayed

wound healing, inflammation and a higher complication rate or more difficult surgery resulting in

staged repair.