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一期管状包皮内板尿道成形术治疗近段型尿道下裂。

One-stage tubularized urethroplasty using the free inner plate of the foreskin in the treatment of proximal hypospadias.

机构信息

Pediatric Urology, Guangdong Maternal and Child Health Hospital, No. 521, Xingnan Avenue, Panyu District, Guangzhou, 511400, China.

出版信息

BMC Pediatr. 2022 Jul 5;22(1):393. doi: 10.1186/s12887-022-03464-2.

Abstract

OBJECTIVE

This study summarizes the short-term efficacy of the one-stage tubularized urethroplasty using the free inner in proximal hypospadias.

METHODS

A retrospective analysis was conducted on 42 patients with proximal hypospadias. All cases were treated with one-stage tubularized urethroplasty from January 2020 to June 2021. The postoperative complications like urethral fistula, urethral stricture, diverticulum, and split penis head were recorded.

RESULTS

Patients were followed up for 3 to 15 months (an average of 8.5 months). A total of 26 cases (62%) were repaired without any complication. Five patients (11.9%) developed urinary fistulas and underwent secondary repair: three cases with anastomotic fistulas and two cases of coronal fistulas. Nine patients (21.4%) had stenosis of the head segment of the penis, six (14.3%) had stenosis that was relieved by urethral dilatation combined with topical mometasone furoate 1 month after urethral catheter removal. Two patients (4.8%) had severe stenosis with secondary surgical stenosis incision, and one (2.4%) had combined urethral diverticulum in which urethral stenosis incision and diverticulectomy were performed.

CONCLUSIONS

Tubularized urethroplasty using the free inner bears the advantages of easy access, reduced short-term complications, low incidence of diverticula.

摘要

目的

本研究总结了一期管状尿道成形术在近端尿道下裂中的短期疗效。

方法

回顾性分析 2020 年 1 月至 2021 年 6 月期间 42 例近端尿道下裂患者。所有病例均采用一期管状尿道成形术治疗。记录术后并发症,如尿道瘘、尿道狭窄、憩室和阴茎头分裂。

结果

患者随访 3 至 15 个月(平均 8.5 个月)。26 例(62%)无并发症修复。5 例(11.9%)发生尿瘘,行二期修复:吻合口瘘 3 例,冠状口瘘 2 例。9 例(21.4%)阴茎头部前段狭窄,6 例(14.3%)在拔除尿道导管后 1 个月行尿道扩张联合局部糠酸莫米松治疗后狭窄缓解。2 例(4.8%)有严重狭窄,行二期手术狭窄切开术,1 例(2.4%)合并尿道憩室,行尿道狭窄切开术和憩室切除术。

结论

游离内层管状尿道成形术具有操作简便、短期并发症少、憩室发生率低等优点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84f1/9254415/2b6c8528aaed/12887_2022_3464_Fig1_HTML.jpg

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