Department of Urology, Ghent University Hospital, Ghent, Belgium.
J Urol. 2013 Jun;189(6):2276-81. doi: 10.1016/j.juro.2012.12.100. Epub 2013 Jan 7.
The field of reconstructive surgery for hypospadias is lacking standard techniques and followup. Most published series include complication rates after a short followup. We report and analyze the long-term outcome of primary hypospadias repair at a single tertiary care center.
We reviewed 1,061 operations performed at our institution between 1997 and 2010 and registered as hypospadias repair. The operations were performed in 543 patients born between June 1997 and June 2005. A retrospective database was created with information about hypospadias characteristics, surgery and followup.
A total of 474 primary repairs were selected, excluding incomplete/incorrect files. Distal penile hypospadias was reported in 366 patients (77.2%), mid penile hypospadias in 54 (11.4%) and proximal hypospadias in 54 (11.4%). Initial repair technique was based on incised plate in 189 patients (39.9%), meatal advancement in 171 (36%), onlay flap in 82 (17.3%) and other or combined techniques in 25 (5.3%). Insufficient information was reported for 7 patients (1.5%). Mean age at first operation was 22.6 months (range 4 to 134) and mean followup after first operation was 34.0 months (0 to 145). Of the children 360 (75.9%) had a good long-term outcome and required only 1 procedure. Reoperation was needed in 114 patients (24.1%), of whom 54 (47.4%) underwent reoperation in the first year of followup.
Overall a good long-term outcome without further complication was achieved in 75.9% of our cases. Of the 24.1% of patients who needed reoperation only 47.4% presented within the first year postoperatively, indicating the need for long-term followup when reporting outcomes of hypospadias repair.
尿道下裂重建领域缺乏标准技术和随访。大多数已发表的系列报道仅包括短期随访后的并发症发生率。我们报告并分析了单中心三级保健机构中初次尿道下裂修复的长期结果。
我们回顾了 1997 年至 2010 年间在我院进行的 1061 例手术，并将其登记为尿道下裂修复术。这些手术是在 1997 年 6 月至 2005 年 6 月间出生的 543 例患者中进行的。创建了一个包含尿道下裂特征、手术和随访信息的回顾性数据库。
排除不完整/不正确的档案后，共选择了 474 例初次修复。366 例（77.2%）患者存在远端阴茎型尿道下裂，54 例（11.4%）患者存在中段阴茎型尿道下裂，54 例（11.4%）患者存在近端尿道下裂。189 例（39.9%）患者采用切开板法，171 例（36%）患者采用尿道口前移术，82 例（17.3%）患者采用游离皮瓣法，25 例（5.3%）患者采用其他或联合技术。7 例（1.5%）患者报告信息不完整。初次手术的平均年龄为 22.6 个月（4 至 134 个月），初次手术后的平均随访时间为 34.0 个月（0 至 145 个月）。360 例（75.9%）患儿的长期结果良好，仅需进行 1 次手术。114 例（24.1%）患儿需要再次手术，其中 54 例（47.4%）在术后 1 年内接受再次手术。
在我们的病例中，75.9%的患儿获得了良好的长期结果，无进一步并发症。24.1%需要再次手术的患儿中，只有 47.4%在术后 1 年内再次手术，这表明在报告尿道下裂修复结果时需要进行长期随访。
