Addis Ababa University, Department of Surgery, Division of Pediatrics Surgery, Addis Ababa, Ethiopia.
Addis Ababa University, Department of Surgery, Division of Pediatrics Surgery, Addis Ababa, Ethiopia.
Urology. 2022 Oct;168:189-194. doi: 10.1016/j.urology.2022.06.022. Epub 2022 Jul 7.
To evaluate the results and related factors of tubularized incised plate (TIP) urethroplasty at two institutions.
This was a prospective cohort analytical study conducted over a period of 12 months. All patients who underwent TIP urethroplasty in the specified period were studied. Quantitative and qualitative data of the intrinsic parameters of the penis were obtained and patients were followed for an average period of 14.72 ± 3.67 months (range 9-21months) after surgery.
One hundred twenty-nine patients (N = 129) were included in the study. The mean age at surgery was 50.93 months. The mean glans size and pre-incised urethral plate width were 14.34 mm and 8.38mm respectively. The post-operative results were satisfactory with the meatus in a glanular position in 122(94.6%) patients. Overall, 49 patients (38%) developed complications. Eighteen patients (14%) developed early complications whereas forty-two (32.6%) patients had late complications. UCF and Meatal stenosis occurred in 27 (20.9%) & 14 (10.9%) patients respectively. Seven patients developed recurrent hypospadias and dehiscence of glans occurred in eight patients (6.2%).
TIP can be used to repair for all types of hypospadias in the absence of severe penile curvature. It has more complication rate in proximal than distal hypospadias. Distal hypospadias were the most common type of hypospadias corrected with TIP. UCF and meatal stenosis were the most common complication followed by glans dehiscence and recurrent hypospadias. Glans size, age at surgery, plate width, location of meatus and stretched penile length were the most determinant factors for the outcome.
评估两家机构的管状切开板(TIP)尿道成形术的结果及相关因素。
这是一项为期 12 个月的前瞻性队列分析研究。研究期间所有接受 TIP 尿道成形术的患者均纳入研究。获取阴茎内在参数的定量和定性数据,并在手术后平均随访 14.72±3.67 个月(范围 9-21 个月)。
研究共纳入 129 例患者。手术时的平均年龄为 50.93 个月。平均龟头大小和预切开尿道板宽度分别为 14.34mm 和 8.38mm。术后结果满意,122 例(94.6%)患者尿道口位于龟头位置。总体而言,有 49 例(38%)患者发生并发症。18 例(14%)发生早期并发症,42 例(32.6%)发生晚期并发症。27 例(20.9%)和 14 例(10.9%)患者分别发生尿道外口狭窄和龟头裂开。7 例患者出现复发性尿道下裂,8 例患者(6.2%)出现龟头裂开。
TIP 可用于修复所有类型的尿道下裂,无严重阴茎弯曲。近端尿道下裂的并发症发生率高于远端尿道下裂。TIP 最常用于矫正远端尿道下裂。尿道外口狭窄和尿道口狭窄是最常见的并发症,其次是龟头裂开和复发性尿道下裂。龟头大小、手术年龄、板宽、尿道口位置和阴茎伸展长度是决定手术结果的最主要因素。