Ozcan Serkan, Bagcioglu Murat, Karakan Tolga, Diri Mehmet Akif, Demirbas Arif
Artvin State Hospital, Urology Department, Artvin, Turkey.
Kafkas University, Faculty of Medicine, Urology Department, Kars, Turkey.
Can Urol Assoc J. 2017 Jan-Feb;11(1-2):E15-E18. doi: 10.5489/cuaj.3944. Epub 2017 Jan 12.
The developments in hypospadias surgical techniques and materials are intended to improve surgery outcomes and patient comfort. The aim of this study is to determine the effect of the Zaontz urethral stent (ZUS) (Cook Medical) on patient comfort and surgical success rates in children undergoing hypospadias surgery.
A feeding tube was used to repair 46 cases of primary distal hypospadias, and ZUS (6F, 8F, and 10F in diameter) was used to repair to 31 cases of primary distal hypospadias between December 2009 and June 2011 in our clinic. ZUS was compared with the feeding tube in terms of surgical success rates and patient comfort in assessments made during postoperative periods.
The patients with ZUS were followed with a stent for seven days postoperatively, as were the patients with the feeding tube. There was no statistical difference between the two groups in terms of fistula formation (p>0.05). Patient comfort was evaluated by the Face, Legs, Activity, Cry, Consolability (FLACC) scale on the first and third postoperative days, and a statistically significant difference was observed in favour of ZUS on the third postoperative day (p<0.05).
Compared with a feeding tube in hypospadias repair, ZUS does not make any contribution to the urinary fistula rates. However, ZUS may have an advantage in terms of patient comfort in the postoperative followup. On the other hand, the small number of patients and the high price of the ZUS were the most important limitations. Prospective, randomized trials are needed to assess efficacy and cost.
尿道下裂手术技术和材料的发展旨在改善手术效果和患者舒适度。本研究的目的是确定Zaontz尿道支架(ZUS,库克医疗公司生产)对接受尿道下裂手术儿童的患者舒适度和手术成功率的影响。
2009年12月至2011年6月期间,在我们诊所,46例原发性远端尿道下裂患者采用喂养管修复,31例原发性远端尿道下裂患者采用ZUS(直径6F、8F和10F)修复。在术后评估中,比较了ZUS和喂养管在手术成功率和患者舒适度方面的差异。
ZUS组患者和喂养管组患者术后均留置支架7天。两组在瘘管形成方面无统计学差异(p>0.05)。术后第1天和第3天采用面部、腿部、活动、哭闹、可安慰性(FLACC)量表评估患者舒适度,术后第3天观察到ZUS组有统计学意义的优势(p<0.05)。
与尿道下裂修复术中使用的喂养管相比,ZUS对尿瘘发生率无影响。然而,在术后随访中,ZUS在患者舒适度方面可能具有优势。另一方面,患者数量少和ZUS价格高是最重要的局限性。需要进行前瞻性随机试验来评估其疗效和成本。