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延长支架留置时间对严重弯曲修复的近端尿道下裂尿道狭窄的影响:一项前瞻性队列研究。

Effect of Prolonging the Duration of Stenting on Urethral Stricture in Proximal Hypospadias with Severe Curvature Repair: A Prospective Cohort Study.

机构信息

Department of Urology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China.

Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, China.

出版信息

Eur J Pediatr Surg. 2024 Aug;34(4):363-367. doi: 10.1055/s-0043-1769797. Epub 2023 Jun 19.

Abstract

INTRODUCTION

The aim of this study was to evaluate whether prolonged stenting reduces the risk of urethral stricture after proximal hypospadias (PH) with severe curvature (SC) repair.

MATERIALS AND METHODS

We prospectively studied a cohort of patients with PH with SC repair who underwent urethral plate transection and urethroplasty between January 2010 and December 2020. According to the duration of stenting, the patients were divided into 2-, 4-, and 6-week groups. Postoperative complications and time of urethral stricture occurrence were analyzed.

RESULTS

In total, 665 patients were included in the analysis. The overall incidence of complications was 26.6% ( = 177), including 42 cases of urethral strictures: 27 (64.3%) cases of urethral stricture occurred between 4 and 6 weeks after urethroplasty, 7 cases occurred between 7 weeks and 6 months after urethroplasty, 7 cases occurred more than 6 months after urethroplasty, and 1 case occurred at 3 weeks after urethroplasty. The incidence of urethral stricture in the 6-week group (1.8%) was significantly lower than that in the 4- (5.8%) and 2-week groups (10.9%) ( < 0.05).

CONCLUSION

Prolonged stenting reduces the risk of urethral stricture in PH with SC repair. Four to six weeks after PH with SC repair may be the key period for the formation of early urethral strictures.

摘要

介绍

本研究旨在评估延长支架留置时间是否会降低严重弯曲型近端尿道下裂(PH)修复后尿道狭窄的风险。

材料与方法

我们前瞻性研究了 2010 年 1 月至 2020 年 12 月期间接受尿道板切开和尿道成形术的严重弯曲型 PH 患者队列。根据支架留置时间,将患者分为 2 周、4 周和 6 周组。分析术后并发症和尿道狭窄发生时间。

结果

共纳入 665 例患者。并发症总发生率为 26.6%( = 177),包括 42 例尿道狭窄:27 例(64.3%)发生在尿道成形术后 4 至 6 周,7 例发生在尿道成形术后 7 周至 6 个月,7 例发生在尿道成形术后 6 个月以上,1 例发生在尿道成形术后 3 周。6 周组(1.8%)尿道狭窄发生率明显低于 4 周组(5.8%)和 2 周组(10.9%)( < 0.05)。

结论

延长支架留置时间可降低严重弯曲型 PH 修复后尿道狭窄的风险。严重弯曲型 PH 修复后 4 至 6 周可能是早期尿道狭窄形成的关键时期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/841d/11226329/3140c43480e8/10-1055-s-0043-1769797-i2023046587oa-1.jpg

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