1. Anne-Françoise Spinoit

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

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

4. Introduction
Dartos
Androgen Receptors
Conclusions

5. Congenital Penile Malformations

6. 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

7. 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

8. Dartos Tissue

10. Corrects (part of) curvature
Surgical observation

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

12. 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

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

14. Introduction
DARTOS
Androgen Receptors
Conclusions

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

16. 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).

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

18. Introduction
Dartos
Androgen receptors
Conclusions

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

20. Androgen receptors expression

21. Androgen receptors expression
Results
Androgen receptors expression
Androgen receptor classification
Negative

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

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

24. 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

25. Androgen receptors expression
Results
Androgen receptors expression

26. Androgen receptors expression
Results
Androgen receptors expression

27. Introduction
Goals of this thesis
Results of studies
Conclusions

28. Conclusions
Dartos
AR expression

29. ~ 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

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

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