Anne-Françoise Spinoit

Dartos, Androgen Receptors and Congenital Penile Malformations Anne-Françoise Spinoit Department of Urology, University Hospital Ghent, Belgium

Dartos, Androgen receptors and CPM’s Conflict of Interest Disclosure I have no potential conflict of interest to report

Introduction Dartos Androgen Receptors Conclusions

Congenital Penile Malformations

Dartos Tissue Superficial peno-scrotal fibro-muscular fascia located just under the skin Originates in Scarpa’s abdominal fascia and Colle’s perineal fascia Superficial to Buck’s deep fascia Dartos Tissue

Dartos Tissue Only Scrotal muscle Sheet of Smooth muscle Sympathetic fibres < genital branch of Genitofemoral nerve (L1,L2) Temperature regulation of the scrotum Temperature important for spermatogenesis Dartos Tissue

Dartos Tissue

Corrects (part of) curvature Surgical observation

Congenital Penile Malformations dartos pathology ~ congenital penile pathologies ? Congenital Penile Malformations

Database Prospective collection (11/2011 ) preputial samples Children undergoing: (CPM’s primary surgery) = cases Hypospadias Buried Penis Epispadias non-medical circumcision = controls Prospectively maintained Database

Database Pathologist Blinded for indication of Surgery (DARTOS STUDIE) Smooth Muscle actin Staining From 2014 On : Androgen Receptors expression Database

Introduction DARTOS Androgen Receptors Conclusions

dartos tissue architecture disorganisation ~ clinical severity (p < 0.001)

DARTOS 183 children 94 hypospadias 1 epispadias 18 buried penis 70 circumcision as control group dartos tissue architecture disorganisation ~ clinical severity (p < 0.001) Median age at surgery 16 months (3-206). Age at surgery : no significant influence (p=0.243).

Congenital penile pathology is associated with abnormal development of the dartos muscle dartos tissue architecture disorganisation ~ clinical severity (p < 0.001)

Introduction Dartos Androgen receptors Conclusions

Androgen receptors expression Androgen receptor in hypospadias : Literature inconclusive Decreased expression in 3 studies Increased expression in 2 studies No association in 2 studies

Androgen receptors expression

Androgen receptors expression Results Androgen receptors expression Androgen receptor classification Negative

Androgen receptors expression Results Androgen receptors expression Androgen receptor classification Negative Weakly positive

Androgen receptors expression Results Androgen receptors expression Androgen receptor classification Negative Weakly positive Positive

Androgen receptors expression Results Androgen receptors expression   Negative Weakly positive Positive Total P value Controls 65 (63.1%) 18 (17.5%) 20 (19.4%) 103 <0.001 Cases 96 (89.7%) 5 (4.7%) 6 (5.6%) 107 Controls versus cases

Androgen receptors expression Results Androgen receptors expression

Androgen receptors expression Results Androgen receptors expression

Introduction Goals of this thesis Results of studies Conclusions

Conclusions Dartos AR expression

~ severity of the condition common disorder of Dartos disorganization of Dartos ~ severity of the condition AR evolve with age in healthy children Such a correlation is not seen in CPM’s AR expression significant lower in CPM’s CPM’s

Common disorder of Dartos in CPM’s ? AR problem in CPM’s ? further research prospective database still running Future Perspectives

Dartos and Androgen Receptors in CPM’s Anne-Françoise Spinoit Department of Urology, University Hospital Ghent, Belgium