Inlay urethroplasty in primary and reoperative hypospadias: evaluation of results with the help of the HOPE and HOSE-score objective scoring systems

Children’s Hospital N 2 of St. Mary Magdalene, Department of Pediatric Surgery and Urology (City Pediatric Uroandrological Center)

Objective

 Introduce a HOPE- and HOSE-score (hypospadias objective penile evaluation) for graft tubularised incised plate urethroplasty (Inlay) for primary and reoperative hypospadias.

Materials and methods

 The retrospective study included 40 patients with hypospadias operated on between 2010 and 2018. The primary hypospadias group (group 1) had 18 patients (45%) with an unsatisfactory urethral site and the reoperative hypospadias group (group 2) had 22 patients (55%). Patients' ages ranged from 8 months to 14 years (mean 16 months). Modified HOPE-score and HOSE-score scoring systems were used to evaluate treatment results.

Results

 The follow-up period ranged from 2 months to 8 years (mean 18 months). Complications: In group N1:  urethral fistula in 2 cases out of 18 (11%). There were no other complications. In group N2: fistula urethra in 2 patients out of 22 (9%); stricture of urethra in 1 case (4.5%). All complications were successfully eliminated. The total percentage of complications was 11% in Group 1 and 13.5% in Group 2.

Conclusions

 Urethroplasty Inlay is an effective method of correction in primary and reoperative hypospadias, which gives good cosmetic and functional results with a low level of complications. The use of the HOPE- and HOSE-score system makes it possible to validate more objectively the long-term and medium-term cosmetic and functional results of operations in primary and reoperative hypospadias.