ESPU Meeting on Thursday 4, September 2025, 15:30 - 16:00
15:40 - 15:43
S14-1 (OP)
Vinaya BHATIA 1, Walid A FARHAT 1, Shannon CANNON 1, Kristin EBERT 1, Emilie JOHNSON 2, Renea STURM 3, Christopher LONG 4, Pankaj DANGLE 5, Lauren CORONA 6, Sebastian HASKE 7 and Jane MAHONEY 8
1) University of Wisconsin-Madison School of Medicine and Public Health, Urology, Madison, USA - 2) Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Urology, Chicago, USA - 3) UCLA, Urology, Los Angeles, USA - 4) Children's Hospital of Philadelphia, Urology, Philadelphia, USA - 5) Riley Children's Hospital, Indiana University School of Medicine, Urology, Indianapolis, USA - 6) Vanderbilt University School of Medicine, Urology, Nashville, USA - 7) University of Wisconsin School of Medicine and Public Health, Urology, Madison, USA - 8) University of Wisconsin School of Medicine and Public Health, Geriatrics and Gerontology, Madison, USA
PURPOSE
Long-term studies of patients treated for hypospadias demonstrated that up to 53% of patients have long-term functional and psychosexual concerns. We hypothesized that multidisciplinary consensus-based screening questionnaire with follow-up guidance could be developed with Modified Delphi methodology.
MATERIAL AND METHODS
We conducted an IRB-approved Modified Delphi including physicians and advance practice providers in pediatrics, urology, psychology, endocrinology, adolescent and adult patients, and parents of patients with hypospadias. A threshold of 75% of participants stating “Agree/Strongly Agree” was considered sufficient for inclusion of the statement in the final questionnaire over 3 iterative rounds of consensus. In the 4th round, respondents were asked to recommend referral services and timeframe based on each concern.
RESULTS
A total of 31 members (24 health care practitioners, 7 families including patients and parents) participated, involving 65 proposed statements. Of the 49 final items in the questionnaire (Table), 25 (50%) mapped to guidance to see a Urologist, while the remaining 25 (50%) mapped to Psychological or Sexual Counselor Referral.
Table
|
Thematic Domain (No. Items) |
Referrals |
Time Frame Range (months) |
|
Penile Function (4) |
Urologist, Endocrinologist |
3-12 |
|
Voiding Function (11) |
Urologist, Primary Care |
3 |
|
Sexual Health (8) |
Psychologist, Sexual Counselor |
3-12 |
|
Social Health (10) |
Psychologist, Urologist, Primary Care
|
3-12
|
|
Psychological Health (7) |
||
|
Doctor-Patient Communication (9) |
CONCLUSIONS
The Delphi method enabled multidisciplinary consensus on a questionnaire that aligns specific concerns with referral guidance for long-term functional and psychosexual monitoring after hypospadias repair. Future research will assess the feasibility and effectiveness of this tool to improve health-related quality of life for patients.
15:43 - 15:46
S14-2 (OP)
Tariq Osman ABBAS 1, Renea STURM 2, Putu Angga RAHARJA 3, Ibrahim ULMAN 4, Grahame SMITH 5, Asma JAMIL 6 and Fatima CHOKOR 7
1) Sidra Medicine, Urology, Doha, QATAR - 2) David Geffen School of Medicine at UCLA, Department of Urology,, Los Angeles, USA - 3) Universitas Indonesia, Department of Urology, Faculty of Medicine, Jakarta, INDONESIA - 4) Ege University, Faculty of Medicine, Department of Urology, Division of Pediatric Urology, Izmir, TÜRKIYE - 5) The Sydney Childrens Hospital Network,, Department of Urology,, Sydney, AUSTRALIA - 6) Sidra Medicine, Department of Urology, Division of Pediatric Urology, Doha, QATAR - 7) College of Health Sciences, Qatar University, Department of Public Health,, Doha, QATAR
PURPOSE
To identify and prioritize critical research questions in hypospadias, a common congenital anomaly in male genitalia, to improve assessment, treatment, and outcome prediction. By combining expert consensus with AI insights, this study aims to establish a roadmap for advancing hypospadias research.
MATERIAL AND METHODS
We employed a Delphi consensus method to prioritize key research questions in hypospadias. Out of 1,867 potential experts identified and invited, 121 experts completed the scoping survey and submitted 156 hypospadias priority research questions. Round 1 involved 11 experts rating 63 of these questions. Additionally, insights from the AI platform ChatGPT were integrated into the process. Feedback from clinicians, researchers, and patient advocates worldwide was collected over multiple rounds. Round 2 expanded the process by incorporating 31 questions proposed by ChatGPT and 9 additional questions from the steering committee.
RESULTS
In round 1, 28 of 63 questions met consensus criteria as critically important, grouped under four main themes: Etiology, Phenotyping, Surgical Techniques, and Post-operative Outcomes. The remaining 35 questions were reviewed, with 11 removed and 24 forwarded to round 2. In round 2, panelists re-rated 85 questions, including 31 proposed by ChatGPT and 9 added by the steering committee. By the end of round 2, 18 additional questions met consensus criteria, bringing the total to 46 critically important research questions. The Delphi process also identified key themes in hypospadias research, including etiology, tissue engineering, pre-clinical models, device/technology evaluation, phenotyping, surgical techniques, surgical training, and postoperative outcomes.
CONCLUSIONS
This Delphi-AI study establishes a prioritized set of research questions in hypospadias. By combining expert consensus with AI insights, these findings will inform future research directions, clinical practice, and innovative approaches to improving outcomes for hypospadias patients globally.
15:46 - 15:49
S14-3 (OP)
Yazan RAWASHDEH 1, Luke HARPER 2, Aybike HOFMANN 3, Raimund STEIN 4, Salvatore CASCIO 5, Rafal CHRZAN 6, Gundela HOLMDAHL 7, Gilvydas VERKAUSKAS 8, Michele GNECH 9, Gloria ROYO GOMES 10, Luis GARCÍA-APARICIO 11, Lukas STEINKELLNER 12, Guy BOGAERT 13, Simona GEROCARNI NAPPO 14, Nicky SMOLDERS 15, Willemijn IRVINE 15 and Magdalena FOSSUM 16
1) Skejby University hospital, Dept. of Urology, Arhus, DENMARK - 2) Bordeaux University hospital, Dept. of Pediatric Urology, Bordeaux, FRANCE - 3) University Medical Center Regensburg, Dept. of Pediatric Urology, Regensburg, GERMANY - 4) University Hospital Mannheim, Dept. of Pediatric Urology, Mannheim, GERMANY - 5) Urology Children's Health Ireland, Dept. of Pediatric Surgery, Dublin, IRELAND - 6) Jagiellonian University, Dept. of Pediatric Urology, Krakow, POLAND - 7) Karolinska University hospital, Dept. of Pediatric Urology, Stockholm, SWEDEN - 8) Faculty of Medicine, Children's Surgery Centre, Vilnius, LITHUANIA - 9) Fondazione IRCCS Ca' Granda, Dept. of Pediatric Urology, Milan, ITALY - 10) Vall d'Hebron University Hospital, Dept. of Pediatric Urology, Barcelona, SPAIN - 11) Pediatric Urology Unit, Dept. of Pediatric Surgery, Barcelona, SPAIN - 12) Hospital of the Sisters of Charity, Dept. of Pediatric Urology, Linz, AUSTRIA - 13) Department of Development and Regeneration, Dept. of Urology, Leuven, BELGIUM - 14) Regina Margherita Hospital, Dept. of Pediatric Urology, Turin, ITALY - 15) Qualicura, Hospitals and Healthcare, Breda, NETHERLANDS - 16) Copenhagen University hospital, Dept. of Pediatric Surgery, Copenhagen, DENMARK
PURPOSE
Posterior Urethral Valves (PUV) is a rare congenital condition characterized by urethral obstruction, significantly impacting long-term bladder and renal function. Evidence-based guidance on PUV management is sparse, leading to variability in clinical practice across Europe. This study aimed to establish clinical consensus statements through a multidisciplinary expert panel within ERN eUROGEN, and a clinical decision support tool, to standardize care and improve outcomes for PUV patients.
MATERIAL AND METHODS
A panel of 15 pediatric urology experts from 10 European countries was convened. A systematic literature review of the last twenty years identified 2,744 relevant studies, which were screened and summarized according to predefined inclusion criteria. Using a modified Delphi method, 80 statements across six key topics—antenatal diagnosis, perinatal management, surgical intervention, bladder management, follow-up, and quality of life—were iteratively reviewed, refined, and voted on over three rounds. Consensus was defined using a 9-point Likert scale with predetermined thresholds.
RESULTS
A total of 47 consensus statements were finalized, covering major aspects of PUV management. Key recommendations include: consultation with pediatric urologists for antenatal suspicion of PUV, proactive lifelong bladder monitoring using non-invasive and invasive methods, and pre-transplant bladder optimization for renal transplantation candidates. Additional statements emphasized the importance of multidisciplinary care, tailored psychosocial support, and addressing quality-of-life issues throughout the patients' life. Evidence levels for the statements ranged from level of evidence 2 to expert opinion.
CONCLUSIONS
These consensus statements provide a framework for standardized, evidence-informed PUV management across Europe. They highlight the importance of proactive, multidisciplinary approaches to improve patient outcomes and quality of life. The process also underscores the value of a collaborative transnational approach, in the furtherance of rare disease management based on best available evidence and the utility of consensus.