Zhao Jian, Sun Ning, Zhang Weiping, Song Hongcheng
Department of Urology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Transl Androl Urol. 2024 Aug 31;13(8):1364-1371. doi: 10.21037/tau-24-135. Epub 2024 Aug 26.
Hypospadias is one of the most common congenital malformations in men. The transverse preputial island urethroplasty is widely used in China, especially for moderate and severe cases due to its convenient prepuce of the penis. This analysis aims to delineate the time to first complication following transverse preputial island urethroplasty.
We analyzed the clinical data and follow-up results of children who underwent hypospadias repair by transverse preputial island urethroplasty in Beijing Children's Hospital, Capital Medical University from December 2018 to December 2019 retrospectively. Postoperative complications included urethral fistula, urethral diverticulum, urethral stricture, persistent chordee. Univariate analysis of clinical variables and time to complication was performed using Kaplan-Meier survival curve.
One hundred and sixty-five patients were identified. During the follow-up period, complications occurred in 101 cases (61.2%). Ninety-four percent of complications occurred within 1 year. Among children who experienced complications, Kaplan-Meier survival analysis showed that age less than 18 months and the severity of hypospadias were statistically significant (P=0.005 and P=0.04, respectively). The time to urethral diverticulum was significantly longer than that of urethral fistula and urethral stricture.
More than 90% of complications after the transverse preputial island urethroplasty of hypospadias occurred within 1 year, with those related to proximal hypospadias presenting earlier than those of midshaft/distal hypospadias. Surgeons may consider a more frequent follow-up within the first year after surgery to detect these complications as early as possible.
尿道下裂是男性最常见的先天性畸形之一。横行包皮岛状皮瓣尿道成形术在中国广泛应用，尤其是对于中重度病例，因其阴茎包皮取材方便。本分析旨在明确横行包皮岛状皮瓣尿道成形术后首次出现并发症的时间。
我们回顾性分析了2018年12月至2019年12月在首都医科大学附属北京儿童医院接受横行包皮岛状皮瓣尿道成形术治疗尿道下裂的患儿的临床资料及随访结果。术后并发症包括尿道瘘、尿道憩室、尿道狭窄、阴茎硬结症。采用Kaplan-Meier生存曲线对临床变量和并发症发生时间进行单因素分析。
共纳入165例患者。随访期间，101例（61.2%）出现并发症。94%的并发症发生在1年内。在发生并发症的患儿中，Kaplan-Meier生存分析显示年龄小于18个月和尿道下裂的严重程度具有统计学意义（分别为P=0.005和P=0.04）。尿道憩室出现的时间明显长于尿道瘘和尿道狭窄。
尿道下裂横行包皮岛状皮瓣尿道成形术后90%以上的并发症发生在1年内，近端尿道下裂相关并发症比阴茎体部/远端尿道下裂出现得更早。外科医生可考虑在术后第1年内更频繁地进行随访，以便尽早发现这些并发症。
