Abdalla Mohamed, Sakr Ahmed, Elgalaly Hazem, Elsayed Ehab, Omran Mohamed
Department of Urology, Zagazig University Faculty of Medicine, Zagazig City, Egypt.
Turk J Urol. 2022 Jan;48(1):74-81. doi: 10.5152/tud.2022.20526.
The objective of this study is to evaluate and compare urethral plate tubularization vs Mathieu in circumcised Megameatus intact prepuce (MIP) repair. Many techniques were described for MIP, which account for 5% of hypospadias cases and usually diagnosed at time of, or even after circumcision.
Forty-six circumcised MIP cases were prospectively enrolled in this prospective study, which was carried out in April 2017 and March 2020. Patients were randomly allocated into two groups. Group one operated by simple urethral plate tubularization and group two by the Mathieu technique. Hypospadias objective scoring evaluation (HOSE) scores, success rate, operative time, and the need for relaxing incision or scrotal flaps for skin closure were compared.
Forty-three circumcised cases (22 in group one and 21 in group two) completed at least 6 months of follow-up. Ages ranged from 12 to 39 months (mean 18.06 6 6.35) in group one and from 10 to 32 months (mean 19.5 6 7.14) in group two. There was no significant difference between cases with accepted outcome based on HOSE scores (14) of the two groups (P value ¼ .942). Three fistulae and one meatal stenosis were the complications in group one (18.2%). In group two, two patients complicated with fistula (9.5%) (P value ¼ .674). Significant differences were present only in the operative time (P ¼ .001) and in the need of relaxing incision or scrotal skin flaps (P ¼ .012) both were more in group two.
Mathieu and tubularized incised plate urethroplasty both are good options for circumcised MIP repair.
本研究的目的是评估和比较包皮环切术后巨尿道口完整包皮（MIP）修复中尿道板管形化术与马蒂厄手术。针对MIP描述了多种技术，MIP占尿道下裂病例的5%，通常在包皮环切术时甚至之后才被诊断出来。
本前瞻性研究于2017年4月至2020年3月进行，前瞻性纳入了46例包皮环切术后的MIP病例。患者被随机分为两组。第一组采用单纯尿道板管形化术，第二组采用马蒂厄技术。比较尿道下裂客观评分评估（HOSE）得分、成功率、手术时间以及皮肤闭合时是否需要松弛切口或阴囊皮瓣。
43例包皮环切术后病例（第一组22例，第二组21例）完成了至少6个月的随访。第一组年龄范围为12至39个月（平均18.06±6.35），第二组年龄范围为10至32个月（平均19.5±7.14）。两组基于HOSE评分（14分）接受结果的病例之间无显著差异（P值 = 0.942）。第一组有3例瘘管和1例尿道口狭窄作为并发症（18.2%）。第二组有2例患者并发瘘管（9.5%）（P值 = 0.674）。仅在手术时间（P = 0.001）以及是否需要松弛切口或阴囊皮瓣方面存在显著差异（P = 0.012），两者在第二组中均更多。
马蒂厄手术和管形切开板尿道成形术都是包皮环切术后MIP修复的良好选择。
