Department of Urology, Children's Hospital of Nanjing Medical University, Jiangsu Provincial Children's Medical Center, Nanjing 210008, China.
Asian J Androl. 2022 Nov-Dec;24(6):639-642. doi: 10.4103/aja202257.
Urethral plate (UP)-preserving urethroplasty is simple and has few complications, but it may affect the development of penis in the long term and lead to recurrent chordee. In this study, we used obliquely cut UP to repair hypospadias with mild chordee after degloving (15°-30°) and compared the results with onlay urethroplasty to explore its rationality and feasibility. Between April 2018 and October 2020, 108 hypospadias patients underwent onlay urethroplasty or modified onlay urethroplasty. Clinical data were prospectively collected, and medium-term outcomes were assessed at follow-up. The complications were compared between the two groups. Forty-four patients underwent the modified onlay procedure (Group I), with follow-up time (mean ± standard deviation [s.d.]) of 23.2 ± 4.5 (range: 17-31) months. Sixty-four patients underwent a standard onlay procedure (Group II), with follow-up time (mean ± s.d.) of 39.7 ± 3.9 (range: 32-46) months. There was no difference in age at surgery. The urethral defect length and operative time were longer in Group I. Six cases of fistula and one case each of stricture and diverticulum were reported in Group I. In Group II, 11 cases of fistula and one case each of stricture and diverticulum were reported. The complication rates were 18.2% and 20.3% in Group I and Group II, respectively (P > 0.05). These medium-term follow-up results demonstrate that the modified onlay procedure (oblique cut UP urethroplasty) is a safe and feasible technique for hypospadias with mild chordee after degloving. Compared with standard onlay urethroplasty, this modified procedure is conducive to the complete removal of scar tissue underlying the UP without increasing the risk of surgical complications.
保留尿道板的尿道成形术操作简单，并发症少，但可能会影响阴茎的长期发育，导致尿道下裂复发。本研究采用斜切尿道板修复脱套后轻度尿道下弯（15°-30°）的尿道下裂，并与尿道板加盖术进行比较，探讨其合理性和可行性。2018 年 4 月至 2020 年 10 月，108 例尿道下裂患者接受了尿道板加盖术或改良尿道板加盖术。前瞻性收集临床资料，随访评估中期结果。比较两组患者的并发症。44 例患者接受改良尿道板加盖术（I 组），随访时间（均数±标准差）为 23.2±4.5（17-31）个月。64 例行标准尿道板加盖术（II 组），随访时间（均数±标准差）为 39.7±3.9（32-46）个月。两组患者的手术年龄差异无统计学意义。I 组患者的尿道缺损长度和手术时间较长。I 组 6 例出现瘘，1 例出现狭窄，1 例出现憩室。II 组中，11 例出现瘘，1 例出现狭窄，1 例出现憩室。I 组和 II 组的并发症发生率分别为 18.2%和 20.3%（P＞0.05）。这些中期随访结果表明，对于脱套后轻度尿道下弯的尿道下裂，改良尿道板加盖术（斜切尿道板尿道成形术）是一种安全可行的技术。与标准尿道板加盖术相比，该改良术式有利于彻底切除尿道板下的瘢痕组织，而不会增加手术并发症的风险。
