Goel Hemant Kumar, Tirthraj Chaure Mayur, Kabra Sumit, Gahlawat Sumit, Sharma Umesh, Sood Rajeev
Department of Urology - Renal Transplant, ABVIMS - Dr. RML Hospital, New Delhi, India.
Department of General Surgery, MGIMS, Wardha, India.
Turk J Urol. 2021 Sep;47(5):420-426. doi: 10.5152/tud.2021.21163.
In our part of the world, many patients present with hypospadias in adult age, where results are often poor and associated with increased complications. This study was conducted to assess the factors affecting outcome of single stage hypospadias surgery in adults.
This study included patients (>12 years) undergoing hypospadias repair in single stage. Preoperative factors were assessed and outcome parameters including early complications (within 1 month) and late complications (after 1 month) were studied and statistically analyzed.
Of the 31 patients included (mean age 20.8 6 7.87 years), 38.7% had a history of previous surgery. Mean glans width was 17.54 6 1.78mm. Postoperatively, the median hospital stay was 5 days (range: 4- 10 days), and the median catheter duration was 21 days (range: 7-21 days). Overall complication rate was 54.83% at 6-month follow-up. Early complications comprised of infection, skin necrosis, and dehiscence of suture line. Late complications included urethrocutaneous fistula, glans dehiscence, and urethral stricture. On performing univariate logistic regression, glans width, urethral plate width and shape, and history of previous surgery were significant risk factors of postsurgery complications. On multivariate logistic regression, glans width was an independent significant risk factor (odds ratio: 0.197).
Several factors are associated with significant complications in adult hypospadias single stage repair. Among the various risk factors, glans width is an independent significant risk factor affecting outcome.
在我们所在的地区,许多患者在成年期出现尿道下裂,手术结果往往不佳且并发症增多。本研究旨在评估影响成人单阶段尿道下裂手术结局的因素。
本研究纳入了(年龄>12岁)接受单阶段尿道下裂修复术的患者。评估术前因素,并对包括早期并发症(1个月内)和晚期并发症(1个月后)在内的结局参数进行研究和统计分析。
纳入的31例患者(平均年龄20.8±7.87岁)中,38.7%有既往手术史。平均龟头宽度为17.54±1.78mm。术后,中位住院时间为5天(范围:4 - 10天);中位导尿管留置时间为21天(范围:7 - 21天)。6个月随访时的总体并发症发生率为54.83%。早期并发症包括感染、皮肤坏死和缝线裂开。晚期并发症包括尿道皮肤瘘、龟头裂开和尿道狭窄。单因素逻辑回归分析显示,龟头宽度、尿道板宽度和形状以及既往手术史是术后并发症的显著危险因素。多因素逻辑回归分析显示,龟头宽度是一个独立的显著危险因素(比值比:0.197)。
成人尿道下裂单阶段修复术中,有几个因素与严重并发症相关。在各种危险因素中,龟头宽度是影响手术结局的一个独立显著危险因素。