Karakus Suleyman Cuneyt, Koku Naim, Parmaksiz Mehmet Ergun, Ertaskin Idris, Kilincaslan Huseyin, Deliaga Hasan
Department of Pediatric Surgery, Gaziantep Children Hospital, Gaziantep, Turkey.
Department of Pediatric Surgery,Faculty of Medicine, BezmialemVakif University, Istanbul, Turkey.
Urol J. 2014 Jan 4;10(4):1095-8.
Meatal stenosis is still a common problem in tubularized incised plate urethroplasty. In this study, we aimed to seek for a relationship between the size of urethral catheter and meatal stenosis formation in children undergoing tubularized incised plate urethroplasty.
We retrospectively reviewed 83 children who underwent tubularized incised plate urethroplasty for hypospadias. The whole group was classified into the groups A and B based on the catheter size. One group (group A) consisted of 44 patients (mean age, 4.82 ± 3.83 years) with tubularized neourethra over a 6 Fr catheter, while the other group (group B) included 39 patients (mean age, 5.19 ± 3.83 years) with tubularized neourethra over a 8 Fr catheter.
There were no significant differences between the groups according to their age, location of urethral meatus, dehiscence and urethrocutaneous fistula formation. Meatal stenosis formation in group B was markedly higher than that in group A. Number of meatal dilatation was higher in group B compared to group A.
We suggest that the tubularization of urethral plate over a small-sized (6 Fr) catheter, regardless of the age of the patients, prevents meatal stenosis by reducing foreign body reaction and pressure injury and by hindering secondary healing.
尿道口狭窄仍是管状切开板尿道成形术中的常见问题。在本研究中,我们旨在探寻接受管状切开板尿道成形术的儿童中尿道导管尺寸与尿道口狭窄形成之间的关系。
我们回顾性分析了83例因尿道下裂接受管状切开板尿道成形术的儿童。根据导管尺寸将整个组分为A组和B组。一组(A组)由44例患者(平均年龄4.82±3.83岁)组成,其管状新尿道置于6F导管上,而另一组(B组)包括39例患者(平均年龄5.19±3.83岁),其管状新尿道置于8F导管上。
两组在年龄、尿道口位置、裂开及尿道皮肤瘘形成方面无显著差异。B组尿道口狭窄形成明显高于A组。B组尿道口扩张次数高于A组。
我们认为,无论患者年龄如何,在小尺寸(6F)导管上进行尿道板管状化,可通过减少异物反应和压力损伤以及阻碍二期愈合来预防尿道口狭窄。