Congenital Malformation of Urinary Tract in Infants and Children
Application of branchedspongiosum repair in duckett surgery for hypospadias
Ling Yu, Jiewen Bao, Yan Chen, Huizhen Sun, Yiqing Lyu, Xiaoxi Li, Li Sun, Hua Xie, Fang Chen, Yichen Huang
Published 2019-11-15
Cite as Chin J Urol, 2019, 40(11): 816-820. DOI: 10.3760/cma.j.issn.1000-6702.2019.11.004
Abstract
ObjectiveTo explore the effect of reducing complication in branched spongiosum repair for hypospadias Duckett surgery.
MethodsRetrospective analysis was performed for the clinical data of 140 surgical infants with hypospadias Duckett surgery from January 2016 to April 2018. According to different covering materials on newly formed urethra, the experimental group (68 cases) cut dysplasia, branched spongiosum and lateral Buck′s fascia from tunica albuginea to coronary groove and then sutured over newly formed urethra, and the control group (72 cases) used Dartos fascia or subcutaneous fascia. The operative age, penile curvature, length of urethral defect, operation time, added value of coronary groove before and after operation, maximum urinary flow rate and complication rate of postoperative follow-up were compared between the two groups, and the therapeutic effect was analyzed.
ResultsThere was no statistically significant difference between two groups in operating time[(135±49)min vs.(135±45)min, P=0.580] and the value added of coronary sulcus[(0.1±0.2)cm vs.(0.1±0.1)cm, P=0.167]. In experimental group, there were 8 cases of urethra percutaneous fistula (11.8%) (coronary groove fistula in 3 cases, 4.4%)and 6 cases of urethral stenosis (8.8%) without urethral dehiscence. In control group, there were 18 cases of urethra percutaneous fistula (25.0%)(coronary groove fistula in 11 cases, 15.3%), 10 cases of urethral stenosis (13.9%), and 2 cases of urethral dehiscence (2.8%). The incidence of postoperative urinary fistula and total complications in experimental group was lower than that in the control group, and the difference was statistically significant (P<0.05), while the incidence of urethral stenosis was not statistically different between two groups (P>0.05). The maximum urine flow rate of experimental group at 6 months after surgery was significantly higher than control group[(9.5±3.8)ml/s vs.(6.8±2.8)ml/s], and the difference was statistically significant (P<0.001).
ConclusionsUrethral cavernosum reconstruction can significantly reduce the incidence of postoperative coronary groove fistula of hypospadias Duckett surgery and improve the postoperative urine flow rate.
Key words:
Hypospadias; Duckett; Urine flow rate; Follow up
Contributor Information
Ling Yu
Department of Urology, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200062, China
Jiewen Bao
Department of Urology, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200062, China
Yan Chen
Department of Urology, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200062, China
Huizhen Sun
Department of Urology, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200062, China
Yiqing Lyu
Department of Urology, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200062, China
Xiaoxi Li
Department of Urology, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200062, China
Li Sun
Department of Urology, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200062, China
Hua Xie
Department of Urology, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200062, China
Fang Chen
Department of Urology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
Yichen Huang
Department of Urology, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200062, China
