Tsachouridis George, Nijman Rien, de Kort Laetitia M O, de Graaf Petra
Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Pediatric Urology, University Medical Center Utrecht, Utrecht, The Netherlands.
Pediatr Surg Int. 2025 Feb 13;41(1):79. doi: 10.1007/s00383-025-05982-3.
Oral mucosa graft urethroplasty (OMGU) is a surgical technique used in complex hypospadias repair. However, long-term outcomes in prepubertal boys, particularly through and after puberty, are not well established. To systematically review the long-term outcomes of OMGU in prepubertal boys with hypospadias, focusing on changes observed after puberty. A systematic literature search was conducted in PubMed, Embase, and Cochrane Library. Studies reporting long-term outcomes of OMGU in prepubertal boys with hypospadias were included. The quality of evidence was assessed using the ROBINS-I tool. Three studies of moderate quality met the inclusion criteria. Outcomes were mixed, with some patients experiencing favorable results and others facing complications such as meatal stenosis, urethral strictures, and fistulas. The scarcity of high-quality, long-term studies highlights a significant knowledge gap in this area. This systematic review reveals insufficient evidence to establish the long-term efficacy and safety of OMGU in prepubertal boys with hypospadias, particularly concerning pubertal development and post-pubertal outcomes. Future research should prioritize prospective, longitudinal studies with larger sample sizes and standardized outcome measures to address these critical gaps in understanding.
口腔黏膜移植尿道成形术（OMGU）是一种用于复杂尿道下裂修复的外科技术。然而，青春期前男孩的长期疗效，尤其是青春期期间及之后的疗效，尚未得到充分证实。为了系统评价OMGU治疗青春期前尿道下裂男孩的长期疗效，重点关注青春期后的变化。在PubMed、Embase和Cochrane图书馆进行了系统的文献检索。纳入报告OMGU治疗青春期前尿道下裂男孩长期疗效的研究。使用ROBINS-I工具评估证据质量。三项中等质量的研究符合纳入标准。结果不一，一些患者取得了良好的效果，而另一些患者则面临诸如尿道口狭窄、尿道狭窄和瘘管等并发症。高质量长期研究的匮乏凸显了该领域存在重大的知识空白。这项系统评价表明，没有足够的证据来确定OMGU治疗青春期前尿道下裂男孩的长期疗效和安全性，特别是在青春期发育和青春期后结果方面。未来的研究应优先进行样本量更大、结局指标标准化的前瞻性纵向研究，以填补这些关键的认知空白。
