Chalmers David J, Siparsky Georgette L, Wiedel Cole A, Wilcox Duncan T
Maine Medical Center, Portland, ME, USA,
Pediatr Surg Int. 2015 Mar;31(3):287-90. doi: 10.1007/s00383-014-3647-y. Epub 2014 Dec 5.
To review our experience with infants undergoing distal hypospadias repair without a postoperative stent to determine if an unacceptable complication rate might justify its use.
Children <1 year of age who underwent distal hypospadias repair by a single surgeon were identified through a prospectively maintained database. The use of a postoperative urethral stent was recorded for each case. Demographics, meatus position, operative technique and complications were also recorded. Patients older than 1 year or with hypospadias proximal to a subcoronal position were excluded.
Eighty-nine patients without a stent were identified in addition to 21 patients who had a stent for a minimum of 3 days. At 3 months follow-up, 4/89 (4.49 %) patients in the stentless group required circumcision revision. 1 patient experienced urinary retention. 1/21 (4.76 %) patients with a postoperative stent required reoperation for meatal stenosis.
The complication rate for infants undergoing distal hypospadias repair is low, does not appear to be significantly increased by forgoing a postoperative urethral stent. Avoiding a stent likely reduces a variety of associated adverse events and needs for short-term follow-up.
回顾我们对未使用术后支架进行远端尿道下裂修复的婴儿的经验，以确定不可接受的并发症发生率是否能证明使用支架的合理性。
通过前瞻性维护的数据库识别由单一外科医生进行远端尿道下裂修复的1岁以下儿童。记录每个病例术后尿道支架的使用情况。还记录了人口统计学资料、尿道口位置、手术技术和并发症。排除1岁以上或尿道下裂位于冠状沟以下位置的患者。
除21例使用支架至少3天的患者外，还识别出89例未使用支架的患者。在3个月的随访中，无支架组的4/89（4.49%）患者需要进行包皮环切术修正。1例患者出现尿潴留。21例术后使用支架的患者中有1/21（4.76%）因尿道口狭窄需要再次手术。
接受远端尿道下裂修复的婴儿并发症发生率较低，不使用术后尿道支架似乎不会显著增加并发症发生率。避免使用支架可能会减少各种相关不良事件以及短期随访的需求。
