Yu Xin, Cao Yong-Sheng, Peng Bo, Liu Xiang, Deng Qi-Fei
Department of Urology, Children's Hospital of Anhui Medical University / Anhui Provincial Children's Hospital, Hefei, Anhui 230051, China.
Zhonghua Nan Ke Xue. 2020 Jan;26(1):54-58.
To compare the effect of midline urethral-plate incision followed by Mathieu urethroplasty (MUPI-MU) with that of tubularized incised-plate (TIP) urethroplasty in the treatment of distal hypospadias.
We retrospectively analyzed the clinical date on 72 cases of distal hypospadias treated in our hospital from August 2016 to January 2019, of which 21 (including 5 cases with a narrow urethral plate, small flat glans and shallow urethral groove) underwent MUPI-MU and the other 51 received TIP urethroplasty. We followed up the patients postoperatively and compared the shape and position of the urethral meatus and incidences of glanular dehiscence, fistula, stenosis and diverticulum between the two groups.
After surgery, the urethral meatus was found vertical, slit-like and in a normal anatomical position in 19 cases (90.5%) in the MUPI-MU and 46 cases (90.2%) in the TIP group, with no statistically significant difference in the shape of the urethral meatus between the two groups (P>0.05). The postoperative incidence of fistula was significantly lower in the MUPI-MU than in the TIP group (1 ［4.8%］ vs 15 ［29.4%］, P = 0.048), and so was that of meatal stenosis (0 vs 12 ［23.5%］, P = 0.037), but no statistically insignificant differences were observed between the MUPI-MU and TIP groups in the incidence of either glanular dehiscence (1 ［4.8%］ vs 2 ［9.8%］, P>0.05) or diverticulum (1 ［4.8%］ vs 6 ［11.8%］, P>0.05). No postoperative complications occurred in the 5 cases with a narrow urethral plate, small flat glans and shallow urethral groove.
MUPI-MU can achieve a normal-looking, vertical, slit-like urethral meatus with a reasonable urethral diameter and minimized incidence of complications, especially applicable to the distal hypospadias patients with a narrow urethral plate, small flat glans and shallow urethral groove.
比较尿道板中线切开后行马蒂厄尿道成形术（MUPI-MU）与管状切开板（TIP）尿道成形术治疗远端尿道下裂的效果。
回顾性分析2016年8月至2019年1月我院收治的72例远端尿道下裂患者的临床资料，其中21例（包括5例尿道板狭窄、阴茎头扁平且尿道沟浅的患者）接受了MUPI-MU手术，另外51例接受了TIP尿道成形术。对患者进行术后随访，比较两组尿道口的形状和位置以及阴茎头裂开、瘘管、狭窄和憩室的发生率。
术后，MUPI-MU组19例（90.5%）和TIP组46例（90.2%）的尿道口呈垂直、裂隙状且位于正常解剖位置，两组尿道口形状差异无统计学意义（P>0.05）。MUPI-MU组术后瘘管发生率显著低于TIP组（1例［4.8%］对15例［29.4%］，P = 0.048），尿道口狭窄发生率也低于TIP组（0例对12例［23.5%］，P = 0.037），但两组阴茎头裂开发生率（1例［4.8%］对2例［9.8%］，P>0.05）和憩室发生率（1例［4.8%］对6例［11.8%］，P>0.05）差异均无统计学意义。5例尿道板狭窄、阴茎头扁平且尿道沟浅的患者术后未出现并发症。
MUPI-MU可使尿道口外观正常、呈垂直裂隙状，尿道直径合理，并发症发生率降至最低，尤其适用于尿道板狭窄、阴茎头扁平且尿道沟浅的远端尿道下裂患者。
