Efficacy comparison between Mathieu combined urethral plate incision and onlay island flap urethroplasty for distal hypospadias in patients with urethral plate stenosis.

Asian journal of andrology Pub Date : 2024-07-01 Epub Date: 2024-06-18 DOI:10.4103/aja202441
Tao Zhang, An-Bang Zhu, Chang-Kun Mao, Yong-Sheng Cao
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Abstract

The aim of the study was to compare the efficacy of Mathieu combined urethral plate incision (Mathieu-IP) versus onlay island flap urethroplasty in patients with distal hypospadias complicated by urethral stenosis. The clinical data of 70 patients with distal hypospadias complicated by urethral plate stenosis treated in the Department of Urology, Anhui Provincial Children's Hospital (Hefei, China), from May 2019 to May 2022, were retrospectively analyzed. Thirty-eight patients underwent Mathieu-IP (Mathieu-IP group) and 32 underwent onlay island flap urethroplasty (Onlay group). Follow-ups at 1 month, 6 months, and 12 months postoperatively assessed operative time, complications, urethral meatus morphology, and family satisfaction. The Mathieu-IP group had significantly shorter operative time (mean ± standard deviation [s.d.]: 81.58 ± 5.18 min) versus the Onlay group (mean ± s.d.: 110.75 ± 6.05 min; P < 0.05). Surgical success rates were 78.9% (Mathieu-IP group) and 75.0% (Onlay group), with no significant difference ( P > 0.05). Complications were comparable between the groups. The Mathieu-IP group resulted in a vertical slit-shaped urethral meatus in 89.5% versus 13.8% in the Onlay group ( P < 0.05). Family satisfaction with general penile appearance and skin shape showed no significant differences, but the Mathieu-IP group had higher satisfaction with meatal position ( P < 0.05). Mathieu-IP offers simplicity, safety, and shorter operative time compared to Onlay. Both the techniques effectively treat urethral plate stenosis in distal hypospadias, with reduced postoperative complications compared to tubularized incised plate urethroplasty. Mathieu-IP results in a vertical slit-shaped urethral meatus which enhances urinary stream, indicating its potential for broader adoption.

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尿道板狭窄患者远端尿道下裂的马蒂厄联合尿道板切开术和嵌顿岛状皮瓣尿道成形术的疗效比较。
摘要:目的比较Mathieu联合尿道板切开术(Mathieu-IP)与嵌顿岛状皮瓣尿道成形术在尿道板狭窄并发远端尿道下裂患者中的疗效。回顾性分析了安徽省儿童医院(中国合肥)泌尿外科2019年5月至2022年5月收治的70例远端尿道下裂并发尿道板狭窄患者的临床资料。38名患者接受了Mathieu-IP术(Mathieu-IP组),32名患者接受了onlay岛状皮瓣尿道成形术(onlay组)。术后1个月、6个月和12个月的随访评估了手术时间、并发症、尿道肉膜形态和家属满意度。Mathieu-IP组的手术时间(平均值±标准差[s.d.]:81.58±5.18分钟)明显短于Onlay组(平均值±标准差:110.75±6.05分钟;P < 0.05)。手术成功率为 78.9%(Mathieu-IP 组)和 75.0%(Onlay 组),无显著差异(P > 0.05)。两组的并发症情况相当。Mathieu-IP组89.5%的患者尿道口呈垂直裂缝状,而Onlay组为13.8%(P < 0.05)。家属对阴茎外观和皮肤形状的总体满意度无明显差异,但 Mathieu-IP 组对肉阜位置的满意度更高(P < 0.05)。与 Onlay 相比,Mathieu-IP 简单、安全,手术时间更短。两种技术都能有效治疗尿道下裂远端尿道板狭窄,与管状切开尿道板尿道成形术相比,术后并发症更少。Mathieu-IP 术后尿道肉腔呈垂直缝隙状,尿流更通畅,因此有可能被更广泛地采用。
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