De Win Gunter, Cuckow Peter, Hoebeke Piet, Wood Dan
Adolescent and Pediatric Urology, University Hospital, Antwerp, Belgium.
Adolescent Urology, University College London Hospitals, UK.
Pediatric Health Med Ther. 2012 Oct 16;3:69-77. doi: 10.2147/PHMT.S25174. eCollection 2012.
Hypospadias is one of the most commonly diagnosed male congenital disorders. Many surgical techniques are described and complications often reported include fistula, wound dehiscence, and meatal stenosis. Many surgeons still believe that hypospadias should be surgically corrected before the age of 12 months. However, it is clear that the longer the follow up, the more complications are reported. Correction of a failed hypospadias repair in adult patients can be challenging. While the need for repair of proximal hypospadias during childhood is evident, distal repair during childhood is questionable. Evidence suggests that the psychosexual and functional outcomes of nonoperated distal hypospadias in the adult population are good. Therefore, the benefit of surgery and the burden of complications must be carefully evaluated. This paper highlights the difficulties inherent in decisions related to the assessment of hypospadias, the need for repair, and the paucity of good long-term data.
尿道下裂是最常见的男性先天性疾病之一。人们描述了许多手术技术，经常报道的并发症包括瘘管、伤口裂开和尿道口狭窄。许多外科医生仍然认为尿道下裂应在12个月龄前进行手术矫正。然而，显然随访时间越长，报道的并发症就越多。成年患者尿道下裂修复失败后的矫正可能具有挑战性。虽然儿童期近端尿道下裂修复的必要性很明显，但儿童期远端修复则存在疑问。有证据表明，成年人群中未手术的远端尿道下裂的心理性和功能性结果良好。因此，必须仔细评估手术的益处和并发症的负担。本文强调了在尿道下裂评估、修复需求及缺乏良好长期数据相关决策中固有的困难。
