Marte A, Di Iorio G, De Pasquale M, Cotrufo A M, Di Meglio D
Department of Paediatrics, Paediatric Surgery, 2nd University of Naples, Naples, Italy.
BJU Int. 2001 Apr;87(6):540-3. doi: 10.1046/j.1464-410x.2001.00090.x.
To determine objectively, using uroflowmetry, the functional results of the tubularized-incised plate urethroplasty to repair midshaft-proximal hypospadias.
Twenty-one patients (mean age 4 years, mean follow-up 1.8 years) were selected from those undergoing surgery between January 1996 and January 1998 at our institution. All patients had midshaft-proximal hypospadias and were treated using the Snodgrass technique. Patients were included if they were able to void volitionally and had no fistula. The flow pattern, maximum (Qmax) and mean flow rate (Qave) were measured; the results were expressed as percentiles and compared with published values from normal children. The Qmax and Qave were considered normal if > 25th percentile, as equivocally obstructed when in the 5-25th percentile and obstructed if < 5th percentile.
Fourteen patients were considered normal, four as equivocally obstructed and three as obstructed. Of the second group, one patient had a urethral diverticulum at the native meatus (confirmed by voiding cysto-urethrography) and the remaining three patients had meatal stenosis that responded to dilatation, with normal flow in two and improvement in the other. Of the obstructed group, one patient responded to dilatation and two underwent meatoplasty.
The tubularized-incised plate repair provides satisfactory functional results for midshaft-proximal hypospadias; uroflowmetry is an important noninvasive tool to evaluate this technique. A long-term follow-up is needed to confirm these results.
通过尿流率测定客观地确定管状切开板尿道成形术修复阴茎中近段尿道下裂的功能结果。
从1996年1月至1998年1月在我院接受手术的患者中选取21例（平均年龄4岁，平均随访1.8年）。所有患者均为阴茎中近段尿道下裂，采用Snodgrass技术进行治疗。若患者能够自主排尿且无瘘管，则纳入研究。测量尿流模式、最大尿流率（Qmax）和平均尿流率（Qave）；结果以百分位数表示，并与正常儿童已发表的值进行比较。若Qmax和Qave大于第25百分位数，则认为正常；若在第5至25百分位数之间，则视为可疑梗阻；若小于第5百分位数，则视为梗阻。
14例患者被认为正常，4例为可疑梗阻，3例为梗阻。在可疑梗阻组中，1例患者在原尿道口处有尿道憩室（经排尿性膀胱尿道造影证实），其余3例患者有尿道口狭窄，经扩张后有反应，2例尿流正常，另1例有所改善。在梗阻组中，1例患者经扩张后有反应，2例接受了尿道口成形术。
管状切开板修复术为阴茎中近段尿道下裂提供了满意的功能结果；尿流率测定是评估该技术的重要无创工具。需要长期随访以证实这些结果。
