<![CDATA[Introduction: Hypospadias repair may cause long-term urinary dysfunction. Collagen, inflammation, and fibrosis may influence urethral healing and urinary flow, but their association with postoperative Qmax remains unclear. Objective: This study aims to investigate the relationship between collagen, inflammation, and fibrosis with maximum urinary flow rate in patients with hypospadias after urethroplasty. Material & Methods: This retrospective cohort study included 72 hypospadias patients who underwent surgery at Ngoerah General Hospital, Denpasar, from 2003 to 2013. Urethral tissue samples were histopathologically assessed for collagen, inflammation, and fibrosis. Urinary flow was evaluated 10 years postoperatively using uroflowmetry, with Qmax categorized based on the optimal ROC-derived cutoff. Associations were analyzed using chi-square and logistic regression. Results: The results showed a significant association between collagen and maximum urinary flow rate (RR=0.573; 95% CI=0.350–0.936; p=0.019), where low collagen levels were protective against weak urinary stream. Moderate-to-severe fibrosis increased the risk of weak urinary stream by 1.6 times (RR=1.659; 95% CI=1.071–2.568; p=0.026). However, no significant association was found between inflammation and maximum urinary flow rate (p=0.964). Logistic regression analysis indicated that patient age was significantly associated with maximum urinary flow rate (OR=1.32; p=0.002). Conclusion: There is an association between collagen levels and maximum urinary flow rate in patients after hypospadias surgery. However, no significant association was found between inflammation and fibrosis with urinary flow. Patient age was the dominant factor influencing urinary flow post-surgery. Keywords: Collagen, inflammation, fibrosis, maximum urinary flow rate, urethroplasty.]]>
