Mekki Mongi, Fredj Myriam Ben, Messaoud Marwa, Youssef Sabrine Ben, Salah Radhouane Ben, Toumi Afef, Sfar Sami, Mosbahi Sana, Ksiaa Amine, Belghith Mohsen, Chakroun Sawssen, Sahnoun Lassaad
Department of Pediatric Surgery, Faculty of Medicine of Monastir, Fattouma Bourguiba Hospital, University of Monastir, Monastir, Tunisia.
Department of Pediatric Anesthesiology and Intensive Care, Faculty of medicine of Monastir, Fattouma Bourguiba Hospital, University of Monastir, Monastir, Tunisia.
Int J Urol. 2024 Dec;31(12):1380-1384. doi: 10.1111/iju.15572. Epub 2024 Sep 4.
The concept of interposing double dorsal preputial flaps to cover the urethroplasty was introduced in 2005 to reduce the risk of urethrocutaneous fistula (UCF). Our study aims to compare the postoperative outcomes of urethroplasty for distal hypospadias between two groups: one receiving single preputial flap coverage and another receiving double flap coverage.
We conducted a retrospective analysis study of boys with primary distal hypospadias who underwent surgery by the same experienced surgeon, at our department between 2010 and 2021. The study population was divided into two groups: Group A, which underwent urethroplasty coverage with single dorsal preputial flap, and Group B, which underwent coverage with double flap. Postoperative complications were compared between the two groups.
We collected 105 cases, comprising 51 in Group A and 54 cases in Group B. The mean age at surgery was 29 months in Group A and 24 months in Group B. Post-operative follow-up period ranged from 6 months to 8 years. Functional and cosmetic outcomes were judged excellent in 88.7%. Only 10 boys experienced complications requiring reoperation. UCF occurred in 5 patients from Group A, while no cases were reported in Group B (p = 0.024). Meatal stenosis was identified in three patients in Group A and in two patients in Group B (p = 1). No other complications, such as glans dehiscence or penile torsion, were noted.
Double dorsal dartos flap is an effective method for covering the new urethra and can be recommended in the treatment of patients with virgin distal hypospadias.
2005年引入了插入双背侧包皮瓣覆盖尿道成形术的概念，以降低尿道皮肤瘘（UCF）的风险。我们的研究旨在比较两组远端尿道下裂患者尿道成形术后的结果：一组接受单包皮瓣覆盖，另一组接受双包皮瓣覆盖。
我们对2010年至2021年在我们科室由同一位经验丰富的外科医生为原发性远端尿道下裂男孩进行手术的情况进行了回顾性分析研究。研究人群分为两组：A组接受单背侧包皮瓣尿道成形术覆盖，B组接受双包皮瓣覆盖。比较两组术后并发症。
我们收集了105例病例，其中A组51例，B组54例。A组手术时的平均年龄为29个月，B组为24个月。术后随访时间为6个月至8年。功能和美容效果评定为优秀的占88.7%。只有10名男孩出现需要再次手术的并发症。A组有5例发生UCF，而B组未报告病例（p = 0.024）。A组有3例患者出现尿道口狭窄，B组有2例（p = 1）。未发现其他并发症，如龟头裂开或阴茎扭转。
双背侧肉膜瓣是覆盖新尿道的有效方法，可推荐用于初发性远端尿道下裂患者的治疗。
