Eur Urol Suppl 2011;10(2):87 ultrasonographic fndings for predicting benign tumors showed a 78% sensitivity, and 92% specifcity. In children older than six months, the combined model predicting benign pathology (alpha-FP < 100 ng/mL and scrotal ultrasonographic fndings suggestive of benign status) showed a 78% sensitivity, 100% specifcity, 100% positive predictive value and an 85% negative predictive value. A testicular preserving procedure was used to treat 13 patients, ten of whom were able to be contacted for long-term follow-up at a mean of 33.6 months following surgery. These patients sustained a mean 81% increase in testicular volume compared to that of the normal contralateral testicle. Imaging of the entire testicle showed that there was recovery from a crescent moon shape to an ovoid shape. Conclusions: Preoperative alpha-FP and ultrasound fndings have high predictive diagnostic values which make them a successful tool for planning testicular preservation surgery. The prognosis of this surgery also seems to be accurate, thus demonstrating successful restoration in low-volume testes. Therefore, for patients with benign testicular tumors, testicular preserving surgery with simultaneous intraoperative biopsy is highly recommended. 205 hyPosPadias rePair, does tyPe of urinary diversion affeCt result? Radwan M.H., Soliman G., Elgamal A., Ghalwash A., Elashry M. Tanta Faculty of Medicine, Dept. of Urology, Tanta, Egypt introduction & objectives: Urinary diversion in hypospadias surgery is an important step. In this study we evaluate different techniques in urinary diversion and urethral stenting in hypospadias surgery. Materials & Methods: It is a prospective randomized study in which 128 patient with distal penile hypospadias were randomily subdivided into 3 groups. All patients underwent tabularized incised plate urethroplasty (TIP). In group (A) urethral catheter used as a stent and for diversion of urine (42 patients), in group (B) we use suprapubic diversion without urethral stenting (42 patients) and in group (C) we use suprapubic diversion and we put a small catheter in the anterior urethra only (44 patients). Urethral catheter in group A was removed at 6-7 postoperative day and in group C the urethral stent was removed at 3-4 postoperative day. Suprapubic catheter was removed at 7-9 days post operatively. All patients received injection antibiotic in the morning of the operation and continued till the day of catheter removal. All of the operations are done by the same surgeon. results: All patients’ characteristics are shown in table 1. Our post operative complications as regards; failure, meatal stenosis and fstula are shown in table 2. Mild bladder spasm occurs in 33% (13 patients) of patients in group A (treated with Oxybutynin) however no such complication occurs in group B or C. We have 2 cases of infection, one in group A and one in group B. The mean hospital stay was 5 days (3-8). The incidence of failure, meatal stenosis and fstula were signifcantly different in the 3 groups. As regards the failure, it was higher in group A (5%) and lower in the other 2 groups. Meatal stenosis was higher in group B (9%) than group A (7) and zero in group C. fstula was higher in group A (11%) than group B (2%) and C (2%). table 1 Group A Group B Group C Total Number Age (mean) Hypospadias Type Repair type 42 1-7 (3) Distal penile TIP 42 1-9 (5) Distal penile TIP 44 1-12 (5) Distal penile TIP 128 table 2 complication Group A Group B Group C Failure Meatal stenosis Fistula 2 (5%) 3 (7%) 5 (11%) 1 (2%) 4 (9%) 1 ( 2%) 0 (0%) 0 (0%) 1 (2%) Conclusions: Suprapubic diversion is an important step in Hypospadias repair specially if it is associated with urethral stent. 206 andrologiCal and CliniCal outCoMe of PaediatriC MiCrosurgiCal laParosCoPiC and MiCrosCoPiC variCoCeleCtoMy. a randoMized ProsPeCtive study Kočvara R. 1 , Sedlaček J. 1 , Dítě Z. 1 , Drlík M. 1 , Zvěřina J. 2 , Zvarova J. 3 1 General University Hospital and Charles University 1st Medical School in Prague, Dept. of Urology, Prague, Czech Republic, 2 General University Hospital and Charles University 1st Medical School in Prague, Dept. of Sexology, Prague, Czech Republic, 3 Czech Academy of Science, Institute of Informatics, Prague, Czech Republic introduction & objectives: Microsurgical (artery and lymphatic sparing) laparoscopic varicocelectomy has been introduced in paediatric patients recently using high laparoscopic optical magnifcation. Comparison with the standard subinguinal microsurgery has not been performed yet. We studied clinical and andrological outcome of these two different microsurgical techniques in children and adolescents in a prospective and randomized study. Materials & Methods: Paediatric patients with unilateral varicocele grade II- III have been randomly assigned to laparoscopic microsurgical repair (Group L, mean age 15.0) or to subinguinal microscopic repair (Group M, mean age 14.4), in both using high magnifcation 15-20 times. In laparoscopy, magnifcation has been achieved by advancing the telescope close to the operating feld with use of telescope holder. Patients with any other testicular pathology were excluded. The protocol contained: age, pubertal stage, testicular size, basal and stimulation LH, FSH and testosterone level; spermiogram in patients > 17 years old. Surgical details and postoperative course were recorded. Only patients with > 1-year follow up were selected for evaluation (57 in group L, 69 in group M). results: After meat 2-year follow up, no hydrocele or testicular atrophy was encountered. Pre and post-operative hormonal parameters from both groups did not differ signifcantly. Pre/post-operative size of the left testis was 9.4/12.4 in Group L and 8.6/12.4 in Group M (p=N.S.), of the right testis 11.4/14.0 and 10.9/14.0, respectively, p=N.S. Testicular hypoplasia persisted in 59.4 % of patients in Group L and in 50 % in Group M. In the laparoscopic repair, mean length of surgery was 75 min., in the microscopic repair 110 min. (after technical modifcation without elevation of the cord 99 min.) (p=0.0001); mean number of divided veins was 6 and 13, respectively (p=0.0001), and periarterial venous network was found in 74 % and 94 % of patients, respectively. No perioperative complications were encountered. Varicocele persisted in no patient in Group L, and in 5.8 % (after modifcation in 3.3 %) in Group M (p=N.S.). Postoperative mean sperm concentration was 62.7 mil/ mL in Group L and 59.1 mil/mL in Group M, progressive fast motility in 30% and 35%, normal sperm morphology in 59% and 61% of patients, respectively (p=N.S.). Conclusions: Clinical and andrological outcome of microsurgical laparoscopic varicocelectomy is comparable to subinguinal microscopic repair. High incidence of periarterial venous network at sub- and also supra-inguinal level requires use of high optical magnifcation. The laparoscopic repair is signifcantly shorter with lower number of veins to be divided. Poster session 18 bPh: laser enuCleation saturday, 19 March, 16.00-17.30, hall C 207 iMPaCt of hosPital voluMe and laser use on in-hosPital Mortality and Morbidity after transurethral surgery of benign Prostate hyPerPlasia; jaPanese diagnosis ProCedure CoMbination database Sugihara T. 1 , Yasunaga H. 2 , Horiguchi H. 2 , Nishimatsu H. 1 , Kume H. 1 , Matsuda S. 3 , Homma Y. 1 1 The University of Tokyo, Dept. of Urology, Tokyo, Japan, 2 The University of Tokyo, Dept. of Health Management and Policy, Tokyo, Japan, 3 University of Occupational and Environmental Health, Dept. of Preventive Medicine and Community Health, Fukuoka, Japan introduction & objectives: Transurethral resection of the prostate is the gold standard therapy for benign prostatic hyperplasia. For minimal invasive therapies laser technology has been introduced to the surgery. We analyzed the impact of annual hospital surgical volume and laser use on postoperative complications and in-hospital mortality in transurethral prostatic surgery. Materials & Methods: The Diagnosis Procedure Combination database is an inpatient care database in Japan that includes administrative claim data and discharge data. The database contains information on diagnoses, comorbidities and complications coded according to International Classifcation of Diseases and Related Health Problems, Tenth Revision; surgical procedures; duration of anaesthesia; volume of blood transfusion; and discharge status. It covered about 40% (2.86 million in 855 hospitals) of all acute care inpatient hospitalizations in 2008. As study samples, patients who were diagnosed with hyperplasia of the prostate, retention of urine or bladder-neck obstruction, and were underwent transurethral resection of the prostate or transurethral laser surgery of the prostate were collected from July 1 to December 31, 2006-2008. Cases were divided into three groups according to annual hospital volume, in low- (<14/year), medium- (14-29/year), or high- (>29/year) volume groups. Multivariate logistic regression analyses were conducted to model the concurrent effects of hospital volume, laser use, and other factors on postoperative complications, transfusion and in-hospital mortality. Postoperative complications include transurethral resection syndrome; sepsis; acute urinary tract infections; injuries of the urethra, rectum or bladder; strokes; cardiac events; venous thromboembolisms; respiratory failures; and ileuses. results: We surveyed 18,578 patients at 686 hospitals. The overall in-hospital mortality was 0.05% (10 of 18,578 patients) and was not signifcantly different between groups. The transfusion rates of the low-, medium- and high-volume groups were 8.3%, 7.0% and 5.5%, respectively (low- vs. high-volume adjusted odds ratio [OR], 1.55; p <0.01), and postoperative complication rates were 3.7%, 3.2% and 2.6% (low- vs. high-volume OR, 1.425; p=0.016), respectively. An absence of laser use was also a signifcant risk factor on both measures (OR, 1.46 and 2.02; both p <0.01). Other signifcant factors associated with higher transfusion rates were teaching hospitals (OR, 1.75), and comorbidity with chronic