Regenerative Medicine Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; Pediatric Urology Division, Surgery Department, Sidra Medicine, Doha, Qatar; College of Medicine, Qatar University, Doha, Qatar; Weill Cornell Medicine - Qatar, Doha, Qatar.
McMaster Children's Hospital, Hamilton, Ontario, Canada.
J Pediatr Urol. 2021 Jun;17(3):316-325. doi: 10.1016/j.jpurol.2021.02.017. Epub 2021 Feb 23.
The variability of the urethral plate (UP) characteristics is one of the factors that influence technical choices for hypospadias correction. However, it is difficult to objectively evaluate the UP, leading to controversies in this subject, and vague terms utilized in the literature to describe its characteristics.
We aim to analyze the previously described methods used to characterize and evaluate UP quality, emphasizing the pros and cons of each system, and highlighting its possible influence on different postoperative outcomes.
We searched the databases PubMed, Embase, and Cochrane Library CENTRAL from January 1, 2000 to August 20, 2020. The following concepts were searched: urethra reconstruction/urethra replacement/urethroplasty AND hypospadias/hypospadias, AND children AND "plate" with the gray literature search. Subgroup analyses were also carried out. The quality of the involved studies was reviewed operating a modified version of the Newcastle-Ottawa Scale (NOS).
996 citations perceived as relevant to screening were retrieved. Thirteen studies were included comprising a total of 1552 cases. The number of patients in each study varied between 42 and 442, and the average post-surgical follow-up duration ranged between 6 months and twenty-six months. All studies used postoperative urethral stents of variable sizes and types. The impact of UP was most frequently assessed for cases treated with the tubularized incised plate (TIP) repair.
The UP quality seems to play a role as an independent factor influencing postoperative outcomes of hypospadias repair. Currently used strategies for the appraisal of UP quality are highly subjective with a low index of generalizability. Various attempts to overcome these limitations exist but none was consistently accepted, leaving a wide space for creative investigation in order to obtain an objective, reproducible, precise, and well-validated tool.
尿道板（UP）特征的可变性是影响尿道下裂矫正技术选择的因素之一。然而，由于难以客观评估 UP，导致该领域存在争议，并且文献中用于描述其特征的术语也很模糊。
我们旨在分析先前描述的用于表征和评估 UP 质量的方法，强调每个系统的优缺点，并强调其对不同术后结果的可能影响。
我们检索了 2000 年 1 月 1 日至 2020 年 8 月 20 日的 PubMed、Embase 和 Cochrane Library CENTRAL 数据库。搜索了以下概念：尿道重建/尿道替代/尿道成形术和尿道下裂/尿道下裂，以及儿童和“板”的灰色文献搜索。还进行了亚组分析。使用改良的纽卡斯尔-渥太华量表（NOS）对纳入研究的质量进行了回顾。
共检索到 996 篇相关文献。纳入了 13 项研究，共纳入 1552 例患者。每项研究的患者人数从 42 到 442 不等，平均术后随访时间为 6 个月至 26 个月。所有研究均使用不同大小和类型的术后尿道支架。UP 的影响最常评估管状切开板（TIP）修复治疗的病例。
UP 质量似乎是影响尿道下裂修复术后结果的独立因素。目前用于评估 UP 质量的策略主观性很强，通用性指数较低。存在各种克服这些局限性的尝试，但没有一种方法被一致接受，为了获得客观、可重复、精确和验证良好的工具，还有很大的创新空间。
