Chen Sen, Yang Zhe, Ma Ning, Wang Wei-Xin, Xu Li-Si, Liu Qi-Yu, Li Yang-Qun
The 2 Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China.
World J Clin Cases. 2021 May 6;9(13):2983-2993. doi: 10.12998/wjcc.v9.i13.2983.
Complex hypospadias is a surgical challenge.
To present the long-term outcomes of two-stage repair of complex hypospadias using a scrotal septal flap.
This was a retrospective study of patients with complex hypospadias who were operated on between January 1, 2001, and January 1, 2019, at a single hospital using a scrotal septal flap (two-stage surgery) or prepuce flap (one-stage surgery; control group). In the scrotal group, the urethra was first repaired using oral mucosa; in the second stage, a scrotal septal flap was used as a second imper-meable layer. Maximal/average urinary flow rates after surgery were compared. All patients were followed for ≥ 6 mo (range: 6-96 mo).
Ninety-seven patients were included (46 in the scrotal group and 51 in the prepuce group). The maximal urinary flow rate was 15.4 ± 2.1 mL/s in the scrotal group and 14.3 ± 3.0 mL/s in the control group ( = 0.035). The average urinary flow rate was 8.4 ± 2.3 mL/s in the scrotal group and 7.5 ± 1.5 mL/s in the control group ( = 0.019). The proportion of patients achieving good therapeutic effects was higher in the scrotal group than in the control group [24 (52.2%) 16 (31.4%), = 0.042; 34 (73.9%) 25 (49.0%), = 0.014]. The scrotal flap two-stage surgery was independently associated with a higher maximal urinary flow rate (OR = 2.416, 95%CI: 1.026-5.689, = 0.044) and with a higher average flow rate (OR = 2.484, 95%CI: 1.054-5.854, = 0.038).
In complex hypospadias, a scrotal septal flap could be a versatile and reliable option for resurfacing the penis.
复杂型尿道下裂是一项外科挑战。
介绍使用阴囊中隔皮瓣进行复杂型尿道下裂两阶段修复的长期效果。
这是一项回顾性研究，研究对象为2001年1月1日至2019年1月1日期间在一家医院接受手术的复杂型尿道下裂患者，这些患者采用阴囊中隔皮瓣（两阶段手术）或包皮皮瓣（一阶段手术；对照组）进行治疗。在阴囊组中，首先使用口腔黏膜修复尿道；在第二阶段，使用阴囊中隔皮瓣作为第二层防渗层。比较术后最大/平均尿流率。所有患者均随访≥6个月（范围：6 - 96个月）。
共纳入97例患者（阴囊组46例，包皮组51例）。阴囊组的最大尿流率为15.4±2.1 mL/s，对照组为14.3±3.0 mL/s（P = 0.035）。阴囊组的平均尿流率为8.4±2.3 mL/s，对照组为7.5±1.5 mL/s（P = 0.019）。阴囊组达到良好治疗效果的患者比例高于对照组[24例（52.2%）对16例（31.4%），P = 0.042；34例（73.9%）对25例（49.0%），P = 0.014]。阴囊皮瓣两阶段手术与较高的最大尿流率独立相关（OR = 2.416，95%CI：1.026 - 5.689，P = 0.044），也与较高的平均尿流率相关（OR = 2.484，95%CI：1.054 - 5.854，P = 0.038）。
在复杂型尿道下裂中，阴囊中隔皮瓣可能是阴茎重建的一种通用且可靠的选择。
