title: Assessment of long term function following hypospadias reconstruction: do flow rates, flow quality and cosmesis improve with time? Results from the modified Bretteville technique.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Plastic Surgery, Ward 11, Ulster Hospital, Dundonald, Belfast BT16 1RH, Northern Ireland, UK. arobinson13@doctors.org.uk
authors.forename: A J
authors.initials: AJ
authors.lastname: Robinson
authors.forename: L E
authors.initials: LE
authors.lastname: Harry
authors.forename: J H
authors.initials: JH
authors.lastname: Stevenson
mesh_terms: D000328:Adult; D004954:Esthetics; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012212:Rheology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014563:Urodynamics; D055815:Young Adult