Department of Urology, Assiut University Hospital, Assiut University, Assiut, Egypt.
J Pediatr Urol. 2012 Jun;8(3):264-7. doi: 10.1016/j.jpurol.2011.05.004. Epub 2011 Jun 8.
To evaluate the impact of prepuce preservation during Mathieu repair for distal hypospadias.
This prospective randomized comparative study, carried out in Assiut University Hospital, between 2006 and 2009, included 200 patients with distal penile or coronal hypospadias. They underwent either Mathieu repair with prepuce preservation (group I, n = 100) or traditional Mathieu repair with circumcision (group II, n = 100). Follow up was at 2 weeks, and 1 and 3 months postoperatively, which only 153 patients completed (I: n = 86 and II: n = 67).
The mean operative time was 64.5 min in group I and 121.7 min in group II (p < 0.001). All patients in group I developed postoperative preputial edema. Patients from group I who had a successful operation underwent circumcision at least 3 months later. Urethrocutaneous fistulae developed in 7 and 6 patients in group I and II respectively (p = 0.967). Fistula closure was done at least 3 months postoperatively, and there was no significant difference in success between the two groups. Two cases of glanular dehiscence were detected (one in each group); the patient from group I had a successful onlay island flap repair.
Preputial preservation during Mathieu repair is a time-saving procedure with similar complication rate to traditional repair. Valuable local tissue is preserved to deal with complications that may occur.
评估 Mathieu 修复术时保留包皮对远端尿道下裂的影响。
本前瞻性随机对照研究于 2006 年至 2009 年在埃及阿西尤特大学医院进行，纳入 200 例远端阴茎或冠状沟型尿道下裂患者。他们接受了 Mathieu 修复术并保留包皮（I 组，n=100）或传统的 Mathieu 修复术并行包皮环切术（II 组，n=100）。术后 2 周、1 个月和 3 个月进行随访，但只有 153 例患者完成了随访（I 组：n=86，II 组：n=67）。
I 组的平均手术时间为 64.5 分钟，II 组为 121.7 分钟（p＜0.001）。I 组所有患者术后均出现包皮水肿。I 组中手术成功的患者至少在 3 个月后行包皮环切术。I 组和 II 组分别有 7 例和 6 例患者发生尿道-皮肤瘘（p=0.967）。瘘管闭合至少在术后 3 个月进行，两组的成功率无显著差异。检测到 2 例龟头裂开（每组各 1 例）；I 组的患者成功行了游离岛状皮瓣修复术。
在 Mathieu 修复术中保留包皮是一种节省时间的手术，其并发症发生率与传统修复术相似。保留有价值的局部组织可处理可能发生的并发症。
