Functional evaluation of the results of hypospadias surgery with uroflowmetry

To determine the role of uroflowmetry in the evaluation of the functional results of hypospadias repair we retrospectively reviewed the records of 32 patients who underwent hypospadias repair with urethral reconstruction (mean age 2.4 years and mean followup 3.6 years). Patients with a plateau pattern and a maximum flow rate 2 standard deviations below the mean for age, body surface and voided volume on more than 1 determination were considered to have urethral obstruction. Urethroplasty had been performed with a meatal based flap in 11 cases, an onlay preputial flap in 5 and a tubularized preputial island flap in 16. Two of 11 patients with a meatal based flap, 5 of 16 with a tubularized preputial island flap and none with an onlay preputial flap had uroflow evidence of urethral stenosis. The 2 patients in the meatal based flap group responded to dilation with a normal flow. Of the tubularized preputial island flap group 3 patients required urethroplasty to correct a stricture and 2 had improvement with dilation alone. Three patients in the tubularized preputial island flap group had normal flow after treatment and 2 had improvement. Only 2 of the 7 patients with strictures were symptomatic. We conclude that uroflow examination is an important noninvasive tool to evaluate the functional results of urethroplasty in children and detect asymptomatic strictures.