Department of Paediatric Surgery, Medical University of Vienna, Austria.
Eur Urol. 2011 Dec;60(6):1184-9. doi: 10.1016/j.eururo.2011.08.031. Epub 2011 Aug 22.
Hypospadias is a challenging field of urogenital reconstructive surgery, with different techniques currently being used.
Evaluate international trends in hypospadias surgery.
DESIGN, SETTING, AND PARTICIPANTS: Paediatric urologists, paediatric surgeons, urologists, and plastic surgeons worldwide were invited to participate an anonymous online questionnaire (http://www.hypospadias-center.info).
General epidemiologic data, preferred technique in the correction of hypospadias, and preferred technique in the correction of penile curvature were gathered.
Three hundred seventy-seven participants from 68 countries returned completed questionnaires. In distal hypospadias (subcoronal to midshaft), the tubularised incised plate (TIP) repair is preferred by 52.9-71.0% of the participants. Meatal advancement and glanuloplasty (MAGPI) is still a preferred method in glandular hypospadias. In the repair of proximal hypospadias, the two-stage repair is preferred by 43.3-76.6%. TIP repair in proximal hypospadias is used by 0.9-16.7%. Onlay flaps and tubes are used by 11.3-29.5% of the study group. Simple plication and Nesbit's procedure are the techniques of choice in curvature up to 30°; urethral division and ventral incision of the tunica albuginea with grafting is performed by about 20% of the participants in severe chordee. The frequency of hypospadias repairs does not influence the choice of technique.
In this study, we identified current international trends in the management of hypospadias. In distal hypospadias, the TIP repair is the preferred technique. In proximal hypospadias, the two-stage repair is most commonly used. A variety of techniques are used for chordee correction. This study contains data on the basis of personal experience. However, future research must focus on prospective controlled trials.
尿道下裂是泌尿生殖重建外科领域的一个具有挑战性的课题，目前有多种技术在应用。
评估尿道下裂手术的国际趋势。
设计、地点和参与者：邀请全球小儿泌尿科医师、小儿外科医师、泌尿科医师和整形外科医师参与这项匿名在线问卷调查（http://www.hypospadias-center.info）。
收集一般流行病学数据、尿道下裂矫正术的首选技术和阴茎弯曲矫正术的首选技术。
来自 68 个国家的 377 名参与者完成了问卷调查。在远端尿道下裂（冠状沟至阴茎干中段）中，52.9%-71.0%的参与者首选管状切开板（TIP）修复术。MAGPI 仍然是治疗尿道下裂的首选方法。在近端尿道下裂的修复中，2 期修复术的首选率为 43.3%-76.6%。TIP 修复术在近端尿道下裂中的使用率为 0.9%-16.7%。皮瓣和管在研究组中的使用率为 11.3%-29.5%。单纯折叠术和 Nesbit 术是曲率小于 30°的首选技术；20%的参与者在严重阴茎下弯时采用尿道切开和白膜切开并植骨术。尿道下裂修复术的频率并不影响技术的选择。
在这项研究中，我们确定了目前国际上尿道下裂管理的趋势。在远端尿道下裂中，TIP 修复术是首选技术。在近端尿道下裂中，两阶段修复术最常用。多种技术用于矫正阴茎弯曲。本研究的数据基于个人经验，但未来的研究必须集中在前瞻性对照试验上。
