Wang Jingzi, Ding Jing, Ma Geng, Ge Zheng, Deng Yongji, Lu Rugang, Guo Yunfei, Chen Chenjun
Department of Urology, Children's Hospital of Nanjing Medical University, Nanjing, China.
Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.
BMC Pediatr. 2025 May 30;25(1):435. doi: 10.1186/s12887-025-05800-8.
Urethral diverticulum (UD) may arise subsequent to hypospadias repair, potentially causing issues such as stone formation, frequent urination, urinary tract infections, urine dripping, and hematuria. We reviewed our previous experiences regarding hypospadias complications to identify the relevant factors affecting the occurrence of UD after hypospadias surgery and adjust management strategies accordingly.
A retrospective analysis was performed on the clinical data of 159 pediatric patients who underwent urethroplasty with disconnection of the urethral plate (DUP) in our department from January 2020 to December 2022. The collected information included patient demographics such as age, weight, Body Mass Index (BMI), Hemoglobin (Hb), Hematocrit (HCT), Albumin (ALB), Prealbumin (PALB), Procalcitonin (PCT), the employed surgical methods, whether the procedure was performed in stages, glans width, urethral stricture, penile curvature after correction, length of urethral defect, length of reconstructed urethra, indwelling catheter size and duration. The study population was divided into a group with UD and a group without UD, and univariate and multivariate analyses were performed.
Among 159 patients with a mean follow-up of 31.87 ± 10.32 months, 14 (8.64%) patients developed UD after urethroplasty surgery. According to the univariate analysis, a narrower glans width (P = 0.018), a higher BMI (P = 0.019), the application of a modified onlay island flap (MOIF, P = 0.003), and urethral stricture (P = 0.010) were significantly associated with postoperative UD. Glans width (P = 0.023, OR = 0.444, 95% confidence interval [CI]: 0.220-0.895), BMI (P < 0.001, odds ratio [OR] = 1.808, 95% CI: 1.318-2.481), the application of MOIF (P = 0.007, OR = 10.670, 95% CI: 1.913-59.505) and urethral stricture (P = 0.015, OR = 10.010, 95% CI: 1.554-64.470) were independent factors for postoperative UD.
A narrower glans width, a higher BMI, the application of MOIF, and urethral stricture are significant factors contributing to the development of UD in patients with hypospadias following DUP.
尿道憩室（UD）可能在尿道下裂修复术后出现，可能导致结石形成、尿频、尿路感染、尿滴沥和血尿等问题。我们回顾了之前关于尿道下裂并发症的经验，以确定影响尿道下裂手术后UD发生的相关因素，并相应调整管理策略。
对2020年1月至2022年12月在我科接受尿道板离断术（DUP）尿道成形术的159例儿科患者的临床资料进行回顾性分析。收集的信息包括患者人口统计学数据，如年龄、体重、体重指数（BMI）、血红蛋白（Hb）、血细胞比容（HCT）、白蛋白（ALB）、前白蛋白（PALB）、降钙素原（PCT）、采用的手术方法、手术是否分期进行、龟头宽度、尿道狭窄、矫正后阴茎弯曲度、尿道缺损长度、重建尿道长度、留置导尿管尺寸和持续时间。研究人群分为有UD组和无UD组，并进行单因素和多因素分析。
159例患者平均随访31.87±10.32个月，14例（8.64%）患者在尿道成形术后发生UD。单因素分析显示，龟头宽度较窄（P = 0.018）、BMI较高（P = 0.019）、应用改良覆盖岛状皮瓣（MOIF，P = 0.003）和尿道狭窄（P = 0.010）与术后UD显著相关。龟头宽度（P = 0.023，OR = 0.444，95%置信区间[CI]：0.220 - 0.895）、BMI（P < 0.001，比值比[OR] = 1.808，95% CI：1.318 - 2.481）、MOIF的应用（P = 0.007，OR = 10.670，95% CI：1.913 - 59.505）和尿道狭窄（P = 0.015，OR = 10.010，95% CI：1.554 - 64.470）是术后UD的独立因素。
龟头宽度较窄、BMI较高、应用MOIF和尿道狭窄是导致DUP术后尿道下裂患者发生UD的重要因素。
