Glanüler tip megameatus intakt sünnet derisi olan olgularda tedavi ne olmalıdır?

Androloji bülteni Pub Date : 2023-01-01 DOI:10.24898/tandro.2023.48295

Kenan Yalçın

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Abstract

OBJECTIVES: We aimed to evaluate the treatment options in patients with glanular type megameatus intact foreskin. MATERIAL and METHODS: Between 2011 and 2021, more than 5000 circumcision procedures were performed in our clinic. The treatment options of 70 cases with glanular type megameatus, which we encountered incidentally when the foreskin was retracted during the circumcision procedure and sometimes we did not know exactly what to do at that moment, were found to be treated retrospectively. Glans approximation procedure (GAP) was applied to 14 of 24 patients who accepted hypospadias surgery. Meatal advancement and glanuloplasty procedure (MAGPI) was performed in 10 of them. The mean age, duration of surgery and surgical intervention results of the cases were evaluated. RESULTS: The mean age of the patients who underwent the GAP procedure was 4.7±1.9, and the duration of surgery was 59.1±6.3 minutes. Urethral stenosis was seen in 1 of 14 cases and urethral fistula complication was observed in 1 of them. The mean age of the patients who underwent the MAGPI procedure was 4.3±1.4, and the duration of surgery was 64.3±3.03 minutes. Urethral stenosis was seen in 1 of 10 cases and unsuccessful surgical complication was observed in 1 of them. Complications developed in 4 (16.66%) of 24 patients. 4 patients underwent re-operation. There was no significant difference in the mean age, duration of surgery and complication rates between the two techniques. CONCLUSION: Intact foreskin conceals clinical findings and megameatus can usually be detected at circumcision attempt. Although the surgery for the glanular type, which is the mildest form of megameatus, is controversial, satisfactory results can be obtained with the appropriate surgical method. In addition, detailed interviews should be made with families before surgery and it should be explained that the operation is controversial. Keywords: glanular, hypospadias, intact foreskin, megameatus

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龟头炎和包皮过长应该如何治疗？

目的:我们的目的是评估治疗方案的患者的腺体型大配子完整包皮。材料和方法:2011年至2021年间，我们诊所进行了5000多例包皮环切手术。我们在包皮环切术中偶然遇到包皮缩回，有时不知道当时该怎么办的70例腺状巨子蚴的治疗方案，发现采用回顾性治疗。在接受尿道下裂手术的24例患者中，有14例采用了龟头逼近术(GAP)。其中10例进行了金属推进和谷粒成形术(MAGPI)。对患者的平均年龄、手术时间及手术干预效果进行评价。结果:行GAP手术的患者平均年龄4.7±1.9岁，手术时间59.1±6.3分钟。14例患者中1例出现尿道狭窄，1例并发尿道瘘。接受MAGPI手术的患者平均年龄为4.3±1.4岁，手术时间为64.3±3.03分钟。10例患者中1例出现尿道狭窄，1例出现手术失败并发症。24例患者中出现并发症4例(16.66%)。4例再次手术。两种技术在平均年龄、手术时间和并发症发生率方面无显著差异。结论:完整的包皮掩盖了临床表现，在包皮环切术中可检出异配子。虽然对于最温和的巨配子腺腺型的手术存在争议，但通过适当的手术方法可以获得满意的结果。此外，术前应与家属进行详细访谈，并说明手术存在争议。关键词:腺状;尿道下裂;完整包皮

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Androloji bülteni

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