Purpose: To investigate the validity and reliability of a home-based, guardian-conducted video voiding test for assessing postoperative voiding function after hypospadias surgery. Materials and Methods: In a single center, patients who had undergone urethroplasty by a single surgeon and postoperative uroflowmetry and video voiding tests conducted between 2008 and 2016 were retrospectively reviewed. Urinary stream was categorized into five grades by three pediatric urologists in a blinded manner. The primary outcome was statistical correlation across raters as measured by Spearman correlation coefficient to validate the interpretation of the video voiding test. The secondary outcome was the reliability of the voiding video test compared with maximum urinary flow rate assessed by uroflowmetry. Results: Thirty-one patients with hypospadias were enrolled. The patients' average ages were 12.3±3.2 months (range, 8-21 months) and 42.8±3.9 months (range, 35-48 months) at the time of surgery and voiding video tests, respectively. Hypospadias was anterior, penile, and proximal in 1 (3.2%), 18 (58.1%), and 12 (38.7%) patients, respectively. The number of patients with each voiding stream grade was as follows: very poor, 4; poor, 4; fair, 13; good, 4; and very good, 6. All intraclass correlation coefficients of the stream grade among the three observers were >0.95. Correlation between the maximum flow rate obtained by use of conventional uroflowmetry and the video voiding stream grade was validated (rho 0.778, p<0.001). Conclusions: The home-based guardian-conducted video voiding test is easy to perform and the present results demonstrate its validity and reliability for assessing patients' post-urethroplasty voiding pattern.

procedure was 39.8 months (range 10.8 -81.2) in the flap patients and 16.4 months (range 5.5 -44.5) in graft patients. The median time to presentation of a complication postoperatively was 3.9 months (range 0.43 e 36.5) in the flap group and 0.56 (range 0.49 e 8.2). In the flap group, 11 patients required another intervention, and of those, 6 required more than one operation. In the graft group, 1 patient required an additional procedure. Flap patients were more likely to be reoperated on (64.7% versus 6.3%, p<0.001). There was no significant difference in post-operative complications between cohorts (64.7% of the buttonhole patients experienced complications versus 31.3% in the free graft patients, p [0.055). There was no significant difference between cohorts in regards to patient age, preoperative testosterone administration, postoperative meatus location, and degree of chordee. None of the pre-operative factors were independently associated with the probability of developing complications using the logistic regression model. There was a significant difference in the proportion of tunneled flaps performed by two attending physicians (35.3%) and the proportion of free grafts performed by two attending physicians (75%), p[0.0221.CONCLUSIONS: Free graft reconstruction is significantly associated with lower re-operation rates compared to tunneled flap repair.