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尿道板预切开宽度和龟头宽度对远端型阴茎下曲畸形行管状化切开尿道板修复术疗效的影响:一项前瞻性研究

The Effect of Pre-Incision Urethral Plate Width and Glanular Width on the Outcome of Tubularized Incised Urethral plate repair surgery in Distal Penile Hypospadias, A prospective study.

机构信息

Urology department, Kafer Elsheikh University, Egypt.

出版信息

Urol J. 2021 Nov 4;19(1):50-55. doi: 10.22037/uj.v18i.6618.

Abstract

PURPOSE

To determine hypospadias repair's cosmetic and functional outcome concerning the urethral plate width and glanular width.

MATERIALS AND METHODS

A prospective study including 38 patients. The urethral plate width (UPW) was measured preoperatively. The cosmetic outcome was evaluated by hypospadias objective penile evaluation [HOPE] score, and the urinary stream evaluated functional outcome. We included boys with distal penile hypospadias and excluded recurrent cases with severe chordee. All patients were operated on by Snodgrass tubularized incised plate repair (TIP); they were followed up for one year. Success was defined as slit-shaped meatus at the tip of the glans without fistula.

RESULTS

The mean age of surgery was 4.5 ± 2.1 years. UPW was < 8 mm in 24 patients (63.2 %) (Group A), while 14 patients (36.8 % ) (Group B) had a UPW ≥ 8 mm. Overall, the mean ± SD of UPW was 4.84 ± 1.29 mm. The mean ± SD of GW was 9.52 ± 1.56 mm. Overall success was documented in 35/38 patients (92.1 %). No significant relation was founded between the complications and UPW of the patients (p-value = 0.7). Overall, the mean ± SD HOPE score was 39.1 ± 8.83. A significant relation was found between the cosmetic outcome of the two groups and the HOPE score (p-value = 0.02).

CONCLUSION

The pre-incision urethral plate width and glanular width were not correlated with the TIP outcome. A better HOPE score is associated with a wide urethral plate.

摘要

目的

探讨尿道板宽度和龟头宽度与尿道下裂修复术美容和功能结果的关系。

材料与方法

前瞻性研究共纳入 38 例患者。术前测量尿道板宽度(UPW)。采用尿道下裂客观阴茎评估[HOPE]评分评估美容效果,尿流动力学评估功能结果。纳入远端阴茎型尿道下裂患儿,排除复发性严重尿道下弯患儿。所有患者均行 Snodgrass 管状切开板修复术(TIP),随访 1 年。成功定义为龟头顶端呈裂隙状尿道口,无瘘管。

结果

手术平均年龄为 4.5 ± 2.1 岁。24 例(63.2%)患者 UPW<8mm(A 组),14 例(36.8%)患者 UPW≥8mm(B 组)。总体而言,UPW 的平均值±标准差为 4.84±1.29mm,GW 的平均值±标准差为 9.52±1.56mm。38 例患者中 35 例(92.1%)手术成功。患者的并发症与 UPW 之间无显著相关性(p 值=0.7)。总体而言,HOPE 评分的平均值±标准差为 39.1±8.83。两组间的美容效果与 HOPE 评分呈显著相关(p 值=0.02)。

结论

术前尿道板宽度和龟头宽度与 TIP 结果无相关性。HOPE 评分较好与尿道板较宽相关。

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