Pediatric surgery unit, Department of surgery, St. Paul's hospital millennium medical college, Addis Ababa, Ethiopia.
Department of surgery, St. Paul's hospital millennium medical college, Addis Ababa, Ethiopia.
Ethiop J Health Sci. 2022 May;32(3):613-622. doi: 10.4314/ejhs.v32i3.18.
Hypospadias repair is one of the commonest and challenging surgery done in pediatric age groups. This study was conducted to assess clinical profiles and surgical outcomes of hypospadias repair.
A retrospective analysis of pediatric hypospadias repairs at St. Paul's hospital millennium medical college from September 2015 to August 2019 was conducted.
A total of 277 patients with hypospadias repair were investigated. The mean age was 3.7+/- 3.5 years (Range, 0.5-14 years) and only one-third (98,35.4%%) of patients were operated on in the recommended age group (6-18 months). Anterior/distal hypospadias was the commonest (123,44.4%) variant identified. The majority (176,63.5%) had chordee and 105(37.9%) were severe forms. Tubularized incised plate repair was the major (164,59.2%) surgical technique employed followed by staged urethroplasty (61,22%). Post-operative complications occurred in 135(48.7%) patients and the commonest was urethrocutanous fistula (95,34.3%). No significant correlation was found between the occurrence of these complications and factors such as age at repair, the severity of hypospadias, presence of concomitant urogenital anomaly, type of procedure and duration of urinary diversion. However, the presence of severe chordee (AOR=3.09; 95%CI 1.21-7.54; p=0.013) was an independent factor found to be associated with postoperative complications on multivariate analysis.
Higher rate of complications following hypospadias repair was observed in our study. Our study also demonstrated no significant advantage of any repair technique in reducing operative complications. Extensive preoperative evaluation, proper operative plan and regular follow-up of such patients is paramount for a better outcome.
尿道下裂修复是小儿外科中最常见和最具挑战性的手术之一。本研究旨在评估尿道下裂修复的临床特征和手术结果。
对 2015 年 9 月至 2019 年 8 月在圣保罗医院千年医疗学院进行的小儿尿道下裂修复术进行回顾性分析。
共调查了 277 例尿道下裂修复患者。平均年龄为 3.7+/-3.5 岁（范围，0.5-14 岁），只有三分之一（98，35.4%）的患者在推荐的年龄组（6-18 个月）进行手术。最常见的是前/远端尿道下裂（123，44.4%）。大多数（176，63.5%）有阴茎弯曲，105 例（37.9%）为严重型。管状切开板修复是主要的（164，59.2%）手术技术，其次是分期尿道成形术（61，22%）。135 例（48.7%）患者发生术后并发症，最常见的是尿道皮肤瘘（95，34.3%）。在多因素分析中，未发现这些并发症的发生与修复时的年龄、尿道下裂的严重程度、合并的泌尿生殖系统异常、手术类型和尿流改道持续时间等因素有显著相关性。然而，严重阴茎弯曲（OR=3.09；95%CI 1.21-7.54；p=0.013）是独立的危险因素。
本研究观察到尿道下裂修复术后并发症发生率较高。本研究还表明，任何修复技术在减少手术并发症方面都没有明显优势。广泛的术前评估、适当的手术计划和对这类患者的定期随访对于获得更好的结果至关重要。
