Assessment of long term function following hypospadias reconstruction: Do flow rates, flow quality and cosmesis improve with time? Results from the modified Bretteville technique

Summary Background Very few studies on long term evaluation of functional outcome following hypospadias reconstruction are available. Results from the modified Bretteville method have shown excellent cosmesis with a low risk of fistula and stenosis. This study addresses the question; do flow rates, quality of urinary stream and cosmesis change over time? Methods A sample of 18 patients who had undergone the 2 stage modified Bretteville technique between 1998 and 2004 were reviewed. Following a mean interval of 10 years and 5 months from initial functional assessment, repeat evaluation was performed using the "HOSE" questionnaire, flowmetry, and spray analysis. Results Improvement in mean flow rate (15.3 vs 10.1 ml/s; p value = 0.0036), reduced spraying (3.2 g vs 4.4 g; p value = 0.2927), with a mean increase in the "HOSE" score (from 13.8 (maximum score 16) to 15.4 (maximum score 16); p value = 0.0440) was observed over the follow up time. Conclusion Improvement in flow rates, flow quality, and cosmesis over a mean interval of 10 years 5 months has been demonstrated in a random cohort of patients undergoing the modified Bretteville method of hypospadias reconstruction.