Androgen Receptors and dartos tissue architecture are abnormal in Congenital Penile Malformations compared to healthy children Analysis of a prospective series Anne-Françoise Spinoit Sarah Buelens, Marleen Praet, Erik Van Laecke, Piet Hoebeke Department of Urology, University Hospital Ghent, Belgium

Introduction Congenital penile malformations ~ dartos tissue structural anomalies. DT is a genital tissue  hormonal dependent ? Pathophysiologic mechanisms ?

Objectives Assess relation between androgen receptors DT structure CPM’s

Methods Foreskin tissue samples prospectively collected since November 2011: Cases: primary penile surgery for CPM (hypospadias, epispadias, buried penis) Controls: non-medical circumcision Histologically analysis : smooth-muscle actin, and since 2013 also with AR antibodies. This analysis concerns only samples processed between 2013 and 2016. Pathologist, blinded for the indication, classified into 3 patters of staining.

Results Negative Weakly positive Positive p-value Controls (n=103) 65 494 samples were stained with SMA 210 were stained with AR antibodies. Median age at surgery was 21 months [4-185]. Negative Weakly positive Positive p-value Controls (n=103) 65 (63.1%) 18 (17.5%) 20 (19.4%) <0.001 Cases (n=107) 96 (89.7%) 5 (4.7%) 6 (5.6%)

Results ARa staining increased with age in controls (p=0.002) in contrary to cases (p=0.850).

Conclusions CPM : with significantly lower AR with significantly DT disorganization compared to controls. AR increases with age in controls, which is not observed in cases with CPM.