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Journals / Journal of Contemporary Medicine / 2018 / Cilt: 8 Sayı: 4

Evaluation of urethral structure after hypospadias surgery with uroflowmetry

Hipospadias Cerrahisi Sonrası Üretral Darlığın Üroflowmetri İle Değerlendirilmesi

Yusuf Atakan Baltrak(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, KOCAELİ DERİNCE SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ)0000-0001-8457-5108
Pages
291–294
Publication Date
2018-12-31
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

When compared with the literature, the maximum flow rate in uroflowmetry measurements is less than 10 ml / s, the average flow rate is low, the voiding curve is the plateau curve and the five-percentile according to the nomograms and the voiding curve smaller than -2 SD results are evaluated in terms of urethral obstruction and urethral dilatation planning is important.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aims: Uroflowmetry is a simple, noninvasive, easy to use and objectively interpretable urodynamic study.
📊
Key Findings & Data:The aim of this study was to evaluate the possible postoperative meatal stenosis in patients who were operated for hypospadias in our clinic with uroflowmetry.
💡
Conclusion & Impact:When compared with the literature, the maximum flow rate in uroflowmetry measurements is less than 10 ml / s, the average flow rate is low, the voiding curve is the plateau curve and the five-percentile according to the nomograms and the voiding curve smaller than -2 SD results are evaluated in terms of urethral obstruction and urethral dilatation planning is important.
🔬Design:Araştırma Makalesi
📍Scope:2015 Verileri
⚙️Variables:Hipospadias · Üroflowmetr · hypospadias

Abstract

Aims: Uroflowmetry is a simple, noninvasive, easy to use and objectively interpretable urodynamic study. Uretral stenosis is the most common late complication after hypospadias surgery. The aim of this study was to evaluate the possible postoperative meatal stenosis in patients who were operated for hypospadias in our clinic with uroflowmetry. Material and Methods: The patients with hypospadias operated in our clinic between January 2015 and January 2017 were determined as our study group.Uroflowmetry and urine flow measurements were performed at least two months after the operation. After uroflowmetry measurement, the residual urine volume was measured by ultrasound device in pediatric surgery clinic. The estimated bladder volumes were calculated according to the age of the patients. Results: The median age of the patients was 7.5 (3-14). In the postoperative period, 9 (19.5%) of the patients had complaints of narrow urination and urination as a clinical complaint. No statistically significant difference was found between the two groups in terms of uroflowmetry results, maximum flow rate, time to reach maximum flow rate, total urine flow time, mean flow rate and residual urine volume (p> 0.005).Sixteen patients (25.4%) in the postoperative group were smaller than <-2SD according to the Siroky nomogram and were in the obstruction group. Conclusions: Uroflowmetry is an easy-to-use noninvasive test used to assess early obstruction and to diagnose a urethral stricture following hypospadias surgery. When compared with the literature, the maximum flow rate in uroflowmetry measurements is less than 10 ml / s, the average flow rate is low, the voiding curve is the plateau curve and the five-percentile according to the nomograms and the voiding curve smaller than -2 SD results are evaluated in terms of urethral obstruction and urethral dilatation planning is important.

Özet

Bu çalışmanın amacı hipospadiaslı olgularda eşlik edebilecek alt üriner sistem obstruksiyonunu üroflowmetri ile değerlendirmek ve bu durumun klinik önemini vurgulamaktır. Kliniğimizde Ocak 2012 - Ocak 2013 tarihleri arasında takip ve tedavisi yapılan hipospadiaslı olguların idrarını tutabilen yaş grubunda olan ve ailesinin işleme yazılı onam verdiği 63 hastaya, ameliyat öncesi poliklinik değerlendirmede ve ameliyat sonrası dönemde eşlik eden alt üriner sistem obstruksiyonu değerlendirmek için üroflowmetri ile idrar akış ölçümleri yapıldı.Tüm hastaların işeme akım eğrisi paternleri tek tek incelendi. Literatüre uygun olarak azami akış hızı, ortalama akış hızı, azami akışa ulaşma süresi, idrar akış süresi, idrar boşaltma süresi, işeme sonrası rezidü idrar miktarı ve işeme eğrisi özelliği ameliyat öncesi ve ameliyat sonrası yapılan üroflowmetri test sonuçları ile karşılaştırıldı.Üroflowmetrinin orta ve uzun vadede hipospadias cerrahisi açısından üretral stenozun ve eşlik eden alt üriner sistem obstruksiyonun erken tanınmasında önemli, ucuz, kolay uygulanabilen non invaziv bir test oldugu düşünülmektedir.

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Cite This Article

Baltrak, Y. A. (2018). Evaluation of urethral structure after hypospadias surgery with uroflowmetry. Journal of Contemporary Medicine, Cilt: 8 Sayı: 4, 291–294. https://doi.org/10.16899/gopctd.408192

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References (71)

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  23. Malyon AD, Boorman JG, Bowley N. Urinary flow rates in hypospadias. Br JPlast Surg. 1997 Oct
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  28. 835–6.40. Tuygun C, Bakirtas H, Gucuk A, Cakici H, Imamoglu A. Uroflow findings inolder boys with tubularized incised-plate urethroplasty. Urol Int. 2009
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  30. 331–3.42. Wolffenbuttel KP, Wondergem N, Hoefnagels JJS et al.Abnormal urine flow in boys withdistal hypospadias before and after correction. J. Urol. 2006
  31. 1733–7.43. Scarpa MG, Castagnetti M, Berrettini A et al. Urinary function after Snodgrass repair ofdistal hypospadias:comparison with the Mathieu repair. Pediatr. Surg. Int. 2010
  32. 519–22.44. Braga LH, Pippi Salle JL, Lorenzo AJ et al. Comparative analysis of tubularized incisedplate versus onlay island flap urethroplasty for penoscrotal hypospadias. J. Urol. 2007
  33. 1451–7.45. Burgu B, Aydogdu O, Söylemez H et al. Both dorsal and ventral flaps can be used inpreviously circumcised hypospadic adults with comparable success rates. Int. Urol.Nephrol.2010
  34. 689–95.46. Marte A, Di Iorio G, De Pasquale M, Cotrufo AM, Di Meglio D. Functional evaluation oftubularized-incised plate repair of midshaft-proximal hypospadias using uroflowmetry. BJUInt. 2001 Apr
  35. 87(6):540-3. PubMed PMID: 11298053.47. Andersson M, Doroszkiewicz M, Arfwidsson C, Abrahamsson K, Holmdahl G.Hypospadias repair with tubularized incised plate: Does the obstructive flow pattern resolvespontaneously? J Pediatr Urol. 2011 Aug
  36. 7(4):441-5. Epub 2010 Jul 13. PubMed PMID:20630805. 1. Snodgrass W. Tubularized, incised plate urethroplasty for distal hypospadias. J Urol1994
  37. Beleza-Meireles A, Omrani D, Kockum I, Frisén L, Lagerstedt K, Nordenskjöld A.Polymorphisms of estrogen receptor beta gene are associated with hypospadias. J EndocrinolInvest2006
  38. Beleza-Meireles A, Töhönen V, Söderhäll C, Schwentner C, Radmayr C, Kockum I, et al.Activating transcription factor 3:a hormone responsive gene in the etiology of hypospadias.Eur J Endocrinol 2008
  39. Sheldon CA, Duckett JW. Hypospadias. Pediatr Clin North Am 1987
  40. Mouriquand PD,Persad R,Sharma S. Hypospadias repair:current principles and procedures.Br J Urol 1995
  41. Sauvage P, Becmeur F, Geiss S, Fath C. Transverse mucozal preputial flap for repair ofsevere hypospadias and isolated chordee without hypospadias: A 350-case experience. JPediatr Surg 1993
  42. Barcat J. Current Concepts of Treatment. Boston: Little,Brown.1973.7. Borer JG,Bauer SB, Peters CA, et al: Tubularized,incised plate urethroplasty:Expended usein primary and repeat surgery for hypospadias. J Urol 2001
  43. Smulian JC, Scorza WE, Guzman ER, Ranzini AC, Vintzileos AM. Prenatal sonographicdiagnosis of midshaft hypospadias. Prenat Diagn 1996
  44. Devesa R,Munoz A,Torrents M, et al. Prenatal diagnosis of isolated hypospadias. PrenatDiadn 1998
  45. Husmann DA, Rathbun SR. Long-term followup of visual internalurethrotomy for management of short (less than 1 cm) penile urethral strictures followinghypospadias repair. J Urol 2006
  46. Brannen GE: Meatal reconstruction. J Urol 1976
  47. Siroky, M.B. 1990. Interpretation of Urinary Flow Rates. Urol. Clin. North Am.Aug
  48. 17(3):537-42.14. Abdelmagid, M. E. and Gajewski, J. B. 1998. Critical Rewiev of the Uroflowmetry,Canadian Journal of Urology. 5(2):569-575.15. Ather, M.H. and Memon, A. 1998. Uroflowmetry and Evaluation of Voiding Disorders.Techniques Urology. 4(3):111-7.16. Abrams, P. 2003. Urodynamics Second Edition. Springer Publishing, 352p. Great Britain.17.Tanagho, E.A. and McAninch J.W. 2003. Smith’s General Urology, 16th Edition. McGrawHill/Appleton &Lange, 830p., SanFrancisco.18. Ding, Y.Y., Lien, P.K. and Choo, P.W. 1998. Use of the Uroflow Study in the Diagnosis ofBladder Outlet Obstruction in Elderly Men. Med J Malaysia. 53(3):209-16.19. Siroky, M.B., Olsson, C.A. and Krane, R.J. 1979. The flow rate nomogram: I. Development.J Urol.Nov
  49. 122(5): 665-8.20. Haylen, B.T., Parys, B.T., Anyaegbunam, W.I., Ashby, D. and West, C.R. 1990. Urine flowrates in male and female urodynamic patients compared with the Liverpool nomograms. Br JUrol. 1990 May
  50. 65(5):483-7.21. Siroky, M.B. 1990. Interpretation of Urinary Flow Rates. Urol. Clin. North Am.Aug
  51. 17(3):537-42.22. Abdelmagid, M. E. and Gajewski, J. B. 1998. Critical Rewiev of the Uroflowmetry,Canadian Journal of Urology. 5(2):569-575.23. Ather, M.H. and Memon, A. 1998. Uroflowmetry and Evaluation of Voiding Disorders.Techniques Urology. 4(3):111-7.24. McClelland, J.L. and Rumelhart, D.E. 1986. Parallel Distributed Processing: Explorationsin the Microstructure of Cognition. The MIT Press.25. Mattsson, S., Lindstrom, S.: Diuresis and voiding pattern in healthy schoolchildren. Br JUrol, 76: 783, 199526.Elser DM, Wyman JF, McClish DK, Robinson D, Fantl JA, Bump RC. The effect of bladdertraining, pelvic floor muscle training, or combination training on urodynamic parameters withurinary incontinence. Continence Program for Research Group. Neurourol Urodyn1999
  52. 427e36.27. Belman AB: Hypospadias
  53. in Welch KJ, Randolph JG, Ravitch MM, O’Neill JA, Rowe MI(eds): Pediatric Surgery29.Van der Werff JFA, Boeve E, Bruse` CA, van der Meulen JC. Urodynamic evaluation ofhypospadias repair. J Urol 1997
  54. 1344–630.Neve´us T, von Gontard A, Hoebeke P, Hja¨lma°s K, Bauer S,Bower W, et al. Thestandardization of terminology of lower urinary tract function in children and adolescents:report from the standardisation committee of the International Children’s Continence Society.J Urol 2006
  55. 314e24.31.Abrams P, Blaivas JG, Stanton SL, Andersen JT. The standardisation of terminology oflower urinary tract function. The International Continence Society Committee onStandardisation of Terminology. Scand J Urol Nephrol 1998
  56. 5e19.32. Kaufman JJ: A new recording uroflometer: asimple automatic device for measuringvoidingvelocity. J Urol 1957
  57. Scott R Jr and McIlhaney JS: The voiding rates in normal male children. J Urol 1959
  58. Malyon AD, Boorman JG, Bowley N. Urinary flow rates in hypospadias. Br JPlast Surg. 1997 Oct
  59. 50(7):530-5. PubMed PMID: 9422951.35. Kajbafzadeh, A. M., Yazdi, C. A., Rouhi, O. et al.: Uroflowmetry nomogram in Iranianchildren aged 7 to 14 years. BMC Urol, 5: 3, 200536. Malyon AD, Boorman J, Bowley N. Urinary flow rates inhypospadias. Br. J. Plast. Surg.1997
  60. 530–5.37. Jayanthi V, Mclorie GA, Khjoury AE et al. Functional characteristics of the reconstructedneourethra after island flap urethroplasty. J. Urol. 1995
  61. 1657–9.38. Tuygun C, Bakirtas H, Gucuk A et al. Uroflow findings in older boys with tubularizedincised-plate urethroplasty. Urol. Int. 2009
  62. 71–6.39. Garibay JT, Reid C, Gonzalez R. Functional evaluation of the results of hypospadias surgerywith uroflowmetry. J. Urol. 1995
  63. 835–6.40. Tuygun C, Bakirtas H, Gucuk A, Cakici H, Imamoglu A. Uroflow findings inolder boys with tubularized incised-plate urethroplasty. Urol Int. 2009
  64. 82(1):71-6. Epub 2009Jan 20. PubMed PMID: 19172101.41. Hammouda HM, El-Ghoneimi A, Bagli DJ et al.Tubularized incised plate repair: functionaloutcome after intermediate followup. J. Urol. 2003
  65. 331–3.42. Wolffenbuttel KP, Wondergem N, Hoefnagels JJS et al.Abnormal urine flow in boys withdistal hypospadias before and after correction. J. Urol. 2006
  66. 1733–7.43. Scarpa MG, Castagnetti M, Berrettini A et al. Urinary function after Snodgrass repair ofdistal hypospadias:comparison with the Mathieu repair. Pediatr. Surg. Int. 2010
  67. 519–22.44. Braga LH, Pippi Salle JL, Lorenzo AJ et al. Comparative analysis of tubularized incisedplate versus onlay island flap urethroplasty for penoscrotal hypospadias. J. Urol. 2007
  68. 1451–7.45. Burgu B, Aydogdu O, Söylemez H et al. Both dorsal and ventral flaps can be used inpreviously circumcised hypospadic adults with comparable success rates. Int. Urol.Nephrol.2010
  69. 689–95.46. Marte A, Di Iorio G, De Pasquale M, Cotrufo AM, Di Meglio D. Functional evaluation oftubularized-incised plate repair of midshaft-proximal hypospadias using uroflowmetry. BJUInt. 2001 Apr
  70. 87(6):540-3. PubMed PMID: 11298053.47. Andersson M, Doroszkiewicz M, Arfwidsson C, Abrahamsson K, Holmdahl G.Hypospadias repair with tubularized incised plate: Does the obstructive flow pattern resolvespontaneously? J Pediatr Urol. 2011 Aug
  71. 7(4):441-5. Epub 2010 Jul 13. PubMed PMID:20630805.