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印度尼西亚儿科泌尿科医生治疗尿道下裂的常见做法:一项来自转诊医院的多中心描述性研究

Common Practice of Hypospadias Management by Pediatric Urologists in Indonesia: A Multi-center Descriptive Study from Referral Hospitals.

作者信息

Duarsa Gede Wirya Kusuma, Tirtayasa Pande Made Wisnu, Daryanto Besut, Nurhadi Pradana, Renaldo Johan, Tarmono Tarmono, Utomo Trisulo, Yuri Prahara, Siregar Safendra, Wahyudi Irfan, Situmorang Gerhard Reinaldi, Palinrungi Muhammad Asykar A, Hutasoit Yonas Immanuel, Hutahaean Andre Yudha Alfanius, Zulfiqar Yevri, Sigumonrong Yacobda H, Mirza Hendy, Rodjani Arry

机构信息

Divison of Urology, Department of Surgery, Faculty of Medicine Universitas Udayana, Sanglah Hospital, Denpasar, Indonesia.

Department of Urology, Faculty of Medicine Universitas Brawijaya, Saiful Anwar Hospital, Malang, Indonesia.

出版信息

Open Access Maced J Med Sci. 2019 Jul 14;7(14):2242-2245. doi: 10.3889/oamjms.2019.628. eCollection 2019 Jul 30.

Abstract

BACKGROUND

Hypospadias is the second most common congenital anomalies among human congenital disabilities. There are over 300 surgery techniques being introduced to treat hypospadias. The successful of hypospadias repair is assessed by several outcomes as well as complications following surgery.

AIM

This study aims to show the multicenter hypospadias data in Indonesia descriptively.

METHODS

All the data were compiled based on questionnaires, which were distributed to Indonesian pediatric urologists. The questionnaire includes several questions containing demographic aspect, preferred techniques being used, and complications being found regarding hypospadias repair.

RESULTS

Eighteen Indonesian pediatric urologists from 12 centres involved in this study. The data were collected from June - September 2018 based on the surgeon's experience throughout 2017. From 591 cases based on the returned questionnaire, penile-type hypospadias was the most common type of hypospadias being treated (35.7%) followed by penoscrotal (28.9%) and scrotal-type (12.9%). Moderate severity of chordee was mostly seen among all cases (40.6%). Tubularised incised plate (TIP), + Thiersch Duplay, was the most common technique being used to treat hypospadias (44.3%), followed by onlay island preputial flap (14.9%) and two-stage technique (14%). The incidence of urethrocutaneous fistulae in this study was 13.9%.

CONCLUSION

This study showed how Indonesian pediatric urologists dealt with hypospadias cases. TIP + Thiersch Duplay procedure being the preferred technique used by most participants and the rate of urethrocutaneous fistulae as one of the complications was comparable with previous studies.

摘要

背景

尿道下裂是人类先天性残疾中第二常见的先天性畸形。目前已有300多种手术技术被用于治疗尿道下裂。尿道下裂修复手术的成功与否通过多种结果以及术后并发症来评估。

目的

本研究旨在描述性地展示印度尼西亚多中心尿道下裂数据。

方法

所有数据基于问卷进行汇编,问卷分发给印度尼西亚的儿科泌尿科医生。问卷包含几个问题,涉及人口统计学方面、所使用的首选技术以及尿道下裂修复相关的并发症。

结果

来自12个中心的18名印度尼西亚儿科泌尿科医生参与了本研究。数据于2018年6月至9月收集,基于外科医生2017年全年的经验。根据回收的问卷,在591例病例中,阴茎型尿道下裂是最常见的治疗类型(35.7%),其次是阴茎阴囊型(28.9%)和阴囊型(12.9%)。所有病例中大多可见中度阴茎弯曲(40.6%)。管状切开板(TIP)+蒂尔施·杜普莱手术是治疗尿道下裂最常用的技术(44.3%),其次是岛状包皮瓣镶嵌术(14.9%)和两阶段技术(14%)。本研究中尿道皮肤瘘的发生率为13.9%。

结论

本研究展示了印度尼西亚儿科泌尿科医生如何处理尿道下裂病例。TIP+蒂尔施·杜普莱手术是大多数参与者首选的技术,尿道皮肤瘘作为并发症之一的发生率与先前研究相当。

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Ethiop J Health Sci. 2018 Nov;28(6):735-740. doi: 10.4314/ejhs.v28i6.8.
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Distal hypospadias repair in infants without a postoperative stent.婴儿无术后支架的远端尿道下裂修复术
Pediatr Surg Int. 2015 Mar;31(3):287-90. doi: 10.1007/s00383-014-3647-y. Epub 2014 Dec 5.
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Hypospadias repair: a single centre experience.尿道下裂修复术:单中心经验
Plast Surg Int. 2014;2014:453039. doi: 10.1155/2014/453039. Epub 2014 Jan 20.
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Failed hypospadias in paediatric patients.小儿患者的尿道下裂失败案例。
Nat Rev Urol. 2013 Nov;10(11):657-66. doi: 10.1038/nrurol.2013.164. Epub 2013 Aug 6.
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Trends in hypospadias surgery: results of a worldwide survey.尿道下裂手术的趋势:一项全球调查的结果。
Eur Urol. 2011 Dec;60(6):1184-9. doi: 10.1016/j.eururo.2011.08.031. Epub 2011 Aug 22.

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