Department of Urology, Children's Hospital of Soochow University, Suzhou, Jiangsu, PR China.
Department of Urology, Children's Hospital of Soochow University, Suzhou, Jiangsu, PR China.
J Pediatr Urol. 2023 Jun;19(3):291.e1-291.e6. doi: 10.1016/j.jpurol.2023.02.002. Epub 2023 Feb 8.
Neourethral covering is an essential technique for preventing complications such as fistula and glans dehiscence in hypospadias repairs. The spongioplasty has been reported for neourethral coverage about 20 years ago. However, reports of the outcome are limited.
This study aimed to retrospectively evaluate the short-term outcome of spongioplasty with Buck's fascia covering dorsal inlay graft urethroplasty (DIGU).
From December 2019 to December 2020, 50 patients with primary hypospadias (median age at surgery, 37 months; range, 10 months-12 years) were treated by a single pediatric urologist. The patients underwent spongioplasty with Buck's fascia covering dorsal inlay graft urethroplasty in single stage. The penile length, glans width, urethral plate width and length, and the location of the meatus of the patients were recorded preoperatively. The patients were followed up,complications noted, and postoperative uroflowmetries at the one-year follow-up time were evaluated.
The average width of glans was 12.92 ± 1.86 mm. A minor penile curvature was observed in all patients (≤30°). The patients were followed up for 12-24 months, and 47 patients (94%) were free from complications. A neourethra formed with a slit-like meatus at the tip of the glans, and the urinary stream was straight. Three patients had coronal fistulae (3/50) and no glans dehiscence, and the mean ± SD Q of postoperative uroflowmetry was 8.13 ± 3.8 ml/s.
This study estimated the short-term outcome of the DIGU covered using spongioplasty with Buck's fascia as the second layer in patients diagnosed with primary hypospadias with a relatively small glans (average width <14 mm). However, only a few reports emphasize spongioplasty with Buck's fascia as the second layer and the DIGU procedure performed on a relatively small glans. The major limitations of this study were its short follow-up time and the retrospective data collection.
Dorsal inlay graft urethroplasty combined with spongioplasty with Buck's fascia as coverage is an effective procedure. In our study, this combination had good short-term outcomes for primary hypospadias repair.
尿道再造术是预防尿道下裂修复术后瘘管和龟头开裂等并发症的重要技术。海绵体成形术大约 20 年前就被报道用于尿道再造术。然而，其结果的报道有限。
本研究旨在回顾性评估使用背侧镶嵌移植物尿道成形术（DIGU）加 Buck 筋膜覆盖的海绵体成形术的短期结果。
2019 年 12 月至 2020 年 12 月，一名小儿泌尿科医生对 50 例原发性尿道下裂患者（手术时中位年龄为 37 个月；范围为 10 个月至 12 岁）进行了治疗。所有患者均采用单阶段海绵体成形术加 Buck 筋膜覆盖背侧镶嵌移植物尿道成形术。记录患者术前的阴茎长度、龟头宽度、尿道板宽度和长度以及尿道口位置。术后随访，记录并发症，并在术后 1 年随访时评估术后尿流率。
平均龟头宽度为 12.92±1.86mm。所有患者均有轻微的阴茎弯曲（≤30°）。患者随访 12-24 个月，47 例（94%）患者无并发症。新尿道在龟头顶端形成裂隙状尿道口，尿流笔直。3 例患者有冠状瘘（3/50），无龟头裂开，术后尿流率的均数±标准差 Q 为 8.13±3.8ml/s。
本研究估计了在诊断为原发性尿道下裂且龟头较小（平均宽度<14mm）的患者中，使用海绵体成形术加第二层 Buck 筋膜作为 DIGU 的短期结果。然而，只有少数报告强调了海绵体成形术加第二层 Buck 筋膜和在较小龟头上行 DIGU 手术。本研究的主要局限性是随访时间短和回顾性数据收集。
背侧镶嵌移植物尿道成形术加海绵体成形术加 Buck 筋膜覆盖是一种有效的方法。在我们的研究中，这种组合对原发性尿道下裂修复有较好的短期效果。
