Clinical value of urodynamics in patients with hypospadias

ABSTRACTClinical Value of Urodynamics in Patients with HypospadiasThe aim of this study is to evaluate the lack of any function which is caused bymeatal stenosis in patients with hypospadias by means of urodynamics and toemphasize the clinical value of this issue.Between January 2005 and July 2006, filling cystometry and uroflowmetry wasperformed in 30 hypospadias patients who did not undergo an operation (Group 1) and32 hypospadias patients who underwent an operation (Group 2). The ages of thepatients were over 4 years in the groups. Only uroflowmetry was performed on 31children who did not have either hypospadias or any other urinary problem (Group 3).No difference was observed in flow rates due to the meatus placement in operative andnonoperative patients.Detrusor overactivity (DO) was foud significantly high (p<0.005) in operativepatients (4 distal and 12 proximal locatious) in compare to nonoperative (7 distal and 8proximal locations) patients.Pollakuria -which is the most prominant clinical finding of hypospadias- wasfound highly significant (p<0.005) in patients with DO(11/15) in Group 1. In Group 2,was also positive (11/16).When location of the meatus is considered, in Group 1 pollakuria wasencountered in 4/19 of distal, and 9/11 proximal located children (p<0.05). In Group 2,4/17 patients with distal and 7/15 proximal location had pollakuria. On the other hand,the incidence of pollakuria droped from 82% to 46.7% in patients with proximalopening after surgery.It is shown that, urodynamic studies in patients with hypospadias shows that thefrequency of pollakiuria increases in paralel with DO increase especially in patientswhose external meatus is proximally located.Key Words: Hypospadias, urodynamics, detrusor overactivityVIII