Zimmermann Eleanor F, Woodward Mark N
Royal Devon and Exeter NHS Foundation Trust, UK.
Department of Paediatric Urology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK.
J Pediatr Urol. 2014 Apr;10(2):399.e1-2. doi: 10.1016/j.jpurol.2013.10.022. Epub 2013 Nov 21.
The aim of this single centre study was to determine: a) the outcome of isolated preputial reconstruction in distal hypospadias and b) overall parental satisfaction.
A retrospective analysis of case notes was performed to determine outcome. Postal parent-satisfaction questionnaires were devised to quantify subjective assessment of care and outcome.
A total of 33 cases of isolated preputial reconstruction were identified between 2006 and 2012. Three sets of notes were untraceable. The median age of the 30 remaining patients at surgery was 23 months (range 11-119). At follow-up, 28 (94%) patients had retractile foreskins that had healed well. One patient (3%) had a foreskin fistula and the parents chose to proceed with circumcision rather than fistula closure. A second patient (3%) developed late phimosis secondary to balanitis xerotica obliterans and also underwent circumcision. Twelve follow-up questionnaires were returned. The median overall success rating of the operation was 4.7/5.0 (94%). All respondents reported that they would recommend the procedure to another parent whose child has a similar diagnosis.
Isolated preputial reconstruction improves the cosmetic appearances in distal hypospadias, has a low complication rate and offers high parental satisfaction.
本单中心研究的目的是确定：a）远端尿道下裂单纯包皮重建的结果；b）家长总体满意度。
对病历进行回顾性分析以确定结果。设计了邮寄式家长满意度问卷，以量化对护理和结果的主观评估。
2006年至2012年期间共确定了33例单纯包皮重建病例。有3套病历无法追踪。其余30例患者手术时的中位年龄为23个月（范围11 - 119个月）。随访时，28例（94%）患者的包皮可回缩且愈合良好。1例患者（3%）出现包皮瘘，家长选择行包皮环切术而非瘘管闭合术。另1例患者（3%）继发干燥性闭塞性龟头炎出现迟发性包茎，也接受了包皮环切术。共收回12份随访问卷。手术的总体成功评分中位数为4.7/5.0（94%）。所有受访者均表示会向其他孩子有类似诊断的家长推荐该手术。
单纯包皮重建可改善远端尿道下裂的外观，并发症发生率低，家长满意度高。
