BACKGROUND: Hypospadias, a common congenital condition in male children, involves an abnormal distal urethral opening. Surgical correction is the primary treatment, and short-term outcomes are well-documented. However, research on long-term voiding outcomes remains limited. This study compares pre- and post-puberty voiding patterns in children who underwent hypospadias correction. METHODS: We conducted a retrospective analysis of 84 male patients treated for hypospadias before the age of 2 years. Inclusion criteria required a minimum 12-year follow-up and availability of uroflowmetry data pre- and post-puberty. The hypospadias were initially treated with Duplay, preputium on-lay, or Duckett techniques. Patients with glandular/coronal hypospadias or urological conditions impacting micturition were excluded. The ICCS criteria were followed for grading the shape of the uroflowmetry. RESULTS: Among the 84 patients, 25 individuals (29.8%) demonstrated prepubertal plateau flows, of which 21 normalized during puberty, resulting in a significantly lower amount of plateau flows post-puberty (Chi-squared, p < 0.001). Three patients (8.0%) required stenosis intervention before or during puberty, as they showed lower urinary tract symptoms. Notably, these 3 patients were distinct from those 21 patients who experienced flow normalization during puberty. CONCLUSIONS: In this study of 84 male hypospadias patients, most experienced flow pattern normalization during puberty, while surgical intervention was only needed in symptomatic cases. Prolonged follow-up significantly reduces the number of patients who could get an intervention based on uroflowmetry shape, thereby optimizing outcomes while minimizing unnecessary procedures. This pragmatic approach aligns with tailored patient care, improving results while reducing interventions.
