Department of Paediatric Surgery, IMS Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Department of Paediatric Surgery, IGIMS, Patna, Bihar, India.
Afr J Paediatr Surg. 2023 Apr-Jun;20(2):102-105. doi: 10.4103/ajps.ajps_125_21.
Hypospadias is a common urological anomaly which could be surgically corrected with good cosmetic results.
We aimed to detect changes in urinary flow parameters both before and after tubularised incised plate urethroplasty (TIPU) using uroflowmetry.
Data collected were clinically implemented hypothesising the probability of urethrocutaneous fistula following stricture with Qmax variation.
This study is a prospective analysis done from December 2017 to October 2019. A total of 104 cases of anterior hypospadias were included in the study. A single surgical unit did TIPU. Pre-operative and post-operative uroflowmetry was done, and Qmax was recorded at 3 months, 6 months and 1 year after surgery. Mean Qmax was calculated for all intervals. A significant decrease in Qmax of a child (<2 standard deviation) was ascertained. Urethral calibration was done in those cases with a significant decrease of Qmax and analysed statistically.
The mean age was 6.97 ± 2.41 years. Out of 104 children, 73 (70.2%) and 31 (29.8%) had distal and mid-shaft hypospadias, respectively. The pre-operative mean Qmax of the population was 6.20 ± 0.42 ml/s. Arithmetic mean Qmax at 3 months, 6 months and 1 year was 8.53 ± 0.42, 11.18 ± 0.47 and 13.71 ± 0.44 ml/s, respectively. On comparing the pre-operative with post-operative mean Qmax, a significant increase was found postoperatively (P < 0.0001). Twenty-four patients had significantly decreased Qmax value after 6 months. In these patients, follow-up urethral dilation was done with significant improvement.
The changes in maximum flow rate (Qmax) are suitable for use in routine follow-up. A significant decrease in Qmax over time indicates the onset of urethral stricture. These cases are to be intervened before venturing to redo urethroplasty.
尿道下裂是一种常见的泌尿系统异常，可通过手术矫正，获得良好的美容效果。
我们旨在通过尿流率测定法检测管状切开板尿道成形术（TIPU）前后尿流参数的变化。
本研究为 2017 年 12 月至 2019 年 10 月期间进行的前瞻性分析。共纳入 104 例前尿道下裂患者。由单一外科小组行 TIPU。术前和术后均进行尿流率测定，术后 3 个月、6 个月和 1 年记录 Qmax。计算所有时间点的平均 Qmax。确定 Qmax 显著降低（<2 个标准差）的患儿。对 Qmax 显著降低的病例进行尿道校准，并进行统计学分析。
平均年龄为 6.97±2.41 岁。104 例患儿中，73 例（70.2%）和 31 例（29.8%）分别为远端和中段尿道下裂。该人群的术前平均 Qmax 为 6.20±0.42ml/s。术后 3 个月、6 个月和 1 年的算术平均 Qmax 分别为 8.53±0.42、11.18±0.47 和 13.71±0.44ml/s。比较术前与术后平均 Qmax，术后明显增加（P<0.0001）。术后 6 个月，24 例患儿 Qmax 值明显降低。在这些患者中，进行了随访性尿道扩张，明显改善。
最大流率（Qmax）的变化适用于常规随访。Qmax 随时间的显著降低表明尿道狭窄的发生。这些病例在进行尿道重建术之前需要进行干预。
