无皮瓣双层尿道成形术治疗阴茎中、远端尿道下裂的疗效。

Mymensingh medical journal : MMJ Pub Date : 2025-01-01
A A Mahmud, N Khan, M B Uddin, M Mokarabin, M F H Siddique, M S Ali, S Muhammod, A Hasan
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引用次数: 0

摘要

尿道下裂是指龟头尖端没有外尿道道,但在阴茎腹面存在。尿道下裂手术是具有挑战性和不断变化的。为了减少并发症,已经做了许多修改。目前广泛应用皮瓣覆盖尿道成形术,但皮瓣本身存在一些并发症。本研究的目的是评估无皮瓣的阴茎中、远端尿道下裂双层尿道成形术的效果。这是一项前瞻性观察性研究,于2021年1月至2023年12月在Mymensingh医学院医院(MMCH)儿科外科和其他几家私立医院进行。共纳入61例患者,随访计划失败7例;最终纳入54例患者。年龄2 ~ 12岁,平均5.8±2.55岁。阴茎远端尿道下裂26例(48.14%),冠状尿道下裂11例(20.37%)。各类型平均手术时间为65.0±10.0分钟。54例患者中48例(88.88%)痊愈,6例(11.11%)出现一种或多种并发症。尿道-皮肤(U-C)瘘5(9.25%)是最常见的并发症,其次是金属狭窄3(5.5%)和残余脊索1(1.8%)。本研究显示,在阴茎中远端尿道下裂手术中,无皮瓣的双层尿道成形术与其他带皮瓣的手术一样安全可行。
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Outcome of Double Layer UrethroplastyWithout Flap in Mid and Distal Penile Hypospadias.

Hypospadias is the absence of external urethral meatus in the tip of the glans but present in the ventral surface of the penis. Hypospadias surgery is challenging and changing. Many modifications have been done to reduce the complications. Currently urethroplasty with flap coverage is widely used but flap itself induces some complications. Aim of this study was to evaluate the outcome of double layer urethroplasty in mid and distal penile hypospadias without flap. This was a prospective type of observational study conducted in the department of pediatric surgery Mymensingh Medical College Hospital (MMCH) and several other private hospitals from January 2021 to December 2023. Total 61 patients were enrolled among them 7 patients failed the follow up schedule; finally 54 patients were included in this study. Age ranges from 2-12 years with mean age 5.8±2.55 years. Maximum 26 (48.14%) patients had distal penile hypospadias followed by coronal hypospadias 11 (20.37%). Mean operative time was 65.0±10.0 minutes for all types. Among the 54 patients, 48(88.88%) were recovered uneventfully and 6(11.11%) patients developed one or more complications. Urethro-cutaneous (U-C) fistula 5(9.25%) were the most common complications followed by meatal stenosis 3(5.5%) and residual chordee 1(1.8%). This study shows double layer urethroplasty without flap in mid and distal penile hypospadias surgery is safe and feasible as other procedures with flap.

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