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成人期尿道下裂修复术:病例系列

Hypospadias repair during adulthood: Case series.

作者信息

AlTaweel Waleed M, Seyam Raouf M

机构信息

Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

出版信息

Urol Ann. 2017 Oct-Dec;9(4):366-371. doi: 10.4103/UA.UA_54_17.

Abstract

PURPOSE

We report our complications and success rate in adult hypospadias repair.

PATIENTS AND METHODS

This was a retrospective study of patients aged ≥17 years who underwent hypospadias repair during 2006-2014. We analyzed two groups, one with primary repair and the other that had secondary repair after failed childhood hypospadias surgery. Outcome was compared between the two groups and among different surgical procedures. Descriptive statistics and Fisher's exact test were used and significance level was set at < 0.05.

RESULTS

Forty patients were included, of which 26 presented for a secondary repair and 14 for primary repair. The meatus was distal in 15 patients, mid-penile in 16, and penoscrotal in 9. The median age of patients at the time of surgery was 21 years (standard deviation [SD] =4, range 17-30). The median follow-up period was 37 months (SD = 8, range 5-75). In the primary repair group, the success rate was 71% (10/14), whereas in the secondary repair group, the success rate was 55% (14/26). The overall complication rate was 60%. Following a subsequent repair, the overall success rate reached 95% (38/40). There was no significant difference in success or complications between patients who presented with primary or secondary hypospadias or between methods of repair.

CONCLUSION

Delayed hypospadias repair in adults is associated with a high success rate of 95% with no difference between primary and secondary repair. Secondary repair however may require more than one procedure most of the time.

摘要

目的

我们报告成人尿道下裂修复手术的并发症及成功率。

患者与方法

这是一项对2006年至2014年间接受尿道下裂修复手术的17岁及以上患者的回顾性研究。我们分析了两组患者,一组为初次修复,另一组为儿童期尿道下裂手术失败后的二次修复。比较了两组之间以及不同手术方法之间的结果。采用描述性统计和Fisher精确检验,显著性水平设定为<0.05。

结果

纳入40例患者,其中26例接受二次修复,14例接受初次修复。尿道口位于阴茎头远端的有15例,阴茎中段的有16例,阴茎阴囊型的有9例。手术时患者的中位年龄为21岁(标准差[SD]=4,范围17 - 30岁)。中位随访期为37个月(SD = 8,范围5 - 75个月)。初次修复组的成功率为71%(10/14),而二次修复组的成功率为55%(14/26)。总体并发症发生率为60%。在后续修复后,总体成功率达到95%(38/40)。初次或二次尿道下裂患者之间或修复方法之间在成功率或并发症方面无显著差异。

结论

成人延迟尿道下裂修复的成功率高达95%,初次修复和二次修复之间无差异。然而,二次修复大多数情况下可能需要不止一次手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdf1/5656964/ce236f9eb7be/UA-9-366-g002.jpg

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