Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen, Guangdong, P.R. China.
Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen, Guangdong, P.R. China.
Urology. 2022 Aug;166:236-240. doi: 10.1016/j.urology.2022.03.022. Epub 2022 Apr 8.
To present our experience with urethral plate (UP) transection to treat hypospadias with severe chordee and examined the effects of this procedure on penile length. The technique involved transecting the UP to correct curvature, facilitating elongation of penile length and reconstruction of the urethra.
We prospectively studied a cohort of patients with hypospadias with severe chordee who underwent UP transection and urethroplasty at our institution between February 2012 and March 2020. The length of the UP defect (length of penile elongation), complications, and patient and urologist satisfaction with penile length were analyzed.
A total of 510 children were included in our study: 78 cases of distal hypospadias and 432 cases of proximal hypospadias. The mean age at initial surgery was 34.84 ± 20.10 months. The length of the UP defect after transection was 2.51 ± 0.92 cm (1.6-8.0 cm). The length of the UP defect gradually increased with age (P < .05). Seven patients were "poorly satisfied" with their penile length after urethroplasty. The median follow-up duration was 32 months. Of the 510 patients, 108 (21.1%) had complications after urethroplasty, including urethral fistulas in 86 cases, urethral strictures in 9 cases, urethral diverticulum in 8 cases and glans dehiscence in 5 cases. During the follow-up period, 7 patients had mild chordee.
Transecting the UP for hypospadias with severe chordee can elongate penile length, reduce the recurrence of curvature, and improve patient satisfaction.
介绍我们在严重阴茎下弯的尿道板（UP）横断术治疗尿道下裂的经验，并探讨该术式对阴茎长度的影响。该技术通过横断 UP 来矫正弯曲，从而有利于阴茎长度的延长和尿道重建。
我们前瞻性研究了 2012 年 2 月至 2020 年 3 月在我院接受 UP 横断术和尿道成形术的严重阴茎下弯型尿道下裂患者队列。分析了 UP 缺损长度（阴茎延长长度）、并发症以及患者和泌尿科医生对阴茎长度的满意度。
本研究共纳入 510 例患儿：78 例远端尿道下裂和 432 例近端尿道下裂。初次手术时的平均年龄为 34.84 ± 20.10 个月。横断 UP 后的 UP 缺损长度为 2.51 ± 0.92cm（1.6-8.0cm）。随着年龄的增长，UP 缺损长度逐渐增加（P <.05）。7 例患者对尿道成形术后的阴茎长度不满意。中位随访时间为 32 个月。510 例患者中，108 例（21.1%）在尿道成形术后出现并发症，包括 86 例尿道瘘、9 例尿道狭窄、8 例尿道憩室和 5 例龟头裂开。随访期间，7 例患者有轻度阴茎下弯。
对于严重阴茎下弯的尿道下裂，横断 UP 可延长阴茎长度，减少弯曲复发，并提高患者满意度。
