Distal hypospadias repairing with foreskin reconstruction

Q4 Medicine

中华小儿外科杂志 Pub Date : 2020-03-15 DOI:10.3760/CMA.J.ISSN.0253-3006.2020.03.013

Wei Liu, Xiangyu Wu, R. Wu

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引用次数: 0

Abstract

Objective To evaluate the efficacy of foreskin reconstruction for distal hypospadias during tubularized incised plate (TIP) repairing. Methods From November 2017 to April 2018, 64 children with distal hypospadias underwent stented TIP urethroplasty. Foreskin reconstruction (n=28) and circumcision (n=36) were performed and compared with regards to operative duration and postoperative complications. Results The operative duration was [(109.9±2.2) vs. (143.8±3.0)] min in foreskin reconstruction and circumcision groups respectively (P<0.0001). Urethroplasty complications occurred in 4(11.1%) circumcision children (fistula, n=1; glans dehiscences, n=2; meatal stenosis, n=1) versus 2(7.1%) after prepucioplasty (fistula, n=1; meatal stenosis, n=1) (P=0.688). Skin complications included preputial dehiscences (n=2, 7.1%) in foreskin reconstruction group and penile torsion (n=1, 2.8%) in circumcision group (P=0.577). The reoperative rate was 10.7% (3/28) in foreskin reconstruction group including fistula repair (n=1) and circumcision (n=2) for foreskin dehiscence versus 8.3% (3/36) in circumcision group including fistula repair (n=1) and glansplasty (n=2) (P=0.746). No significant inter-group differences existed in urethroplasty and skin complications or reoperative rate. Conclusions During TIP repairing, foreskin reconstruction is a time-saving procedure with similar complication and reoperative rate to traditional technique. Prepuce preservation may hide most penile malformations and provide valuable local tissues for dealing with potential complications. Foreskin reconstruction is a surgical alternative for distal hypospadias using TIP repair based upon prepuce appearance and parental preference. Key words: Hypospadias; Foreskin; Postoperative complications

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远端尿道下裂包皮重建术修复

目的探讨包皮重建在尿道下裂管状切开钢板(TIP)修复术中的应用效果。方法2017年11月至2018年4月，对64例远端尿道下裂患儿行TIP尿道成形术。对包皮重建(n=28)和包皮环切(n=36)进行手术时间和术后并发症的比较。结果包皮重建术组和包皮环切术组手术时间分别为[(109.9±2.2)vs(143.8±3.0)]min (P<0.0001)。包皮环切术患儿4例(11.1%)发生尿道成形术并发症(瘘管，n=1;龟头开裂，n=2;术前成形术(瘘管，n=1;金属狭窄，n=1) (P=0.688)。皮肤并发症包皮重建组包皮开裂(n=2, 7.1%)，包皮环切组阴茎扭转(n=1, 2.8%) (P=0.577)。包皮修补组(n=1)包皮环切术(n=2)包皮环切术(n=1)包皮环切术(n=2)包皮环切术(n=1)包皮环切术(n=1)包皮环切术(n=1)包皮环切术(n=2)包皮环切术(n= 0.746)包皮环切术的再手术率为10.7%(3/28)。尿道成形术、皮肤并发症及再手术率组间差异无统计学意义。结论在TIP修复中，包皮重建术与传统方法相比，并发症少，再手术率低，节省了手术时间。包皮保存可以隐藏大多数阴茎畸形，并为处理潜在的并发症提供有价值的局部组织。包皮重建是基于包皮外观和父母偏好使用TIP修复远端尿道下裂的一种外科选择。关键词:尿道下裂;包皮;术后并发症

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来源期刊

中华小儿外科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.40

自引率

0.00%

发文量

8707

期刊介绍： Chinese Journal of Pediatric Surgery is an academic journal sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. The journal was founded in 1980 and is included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences) and CSCD Chinese Science Citation Database Source Journal (including extended version). It is one of the national key academic journals under the supervision of the China Association for Science and Technology. Chinese Journal of Pediatric Surgery enjoys a high reputation and influence in the academic community. The articles published in this journal have a high academic level and practical value, providing readers with a large number of practical cases and industry information, and have received widespread attention and citations from readers.