ABSTRACT
Objective To evaluate if strategic urethrostomy could reduce complications in complicated hypospadias repair.Methods From January 2016 to August 2018,165 patients of complicated hypospadias were reviewed according to inclusion criteria.They were divided into three groups of one-stage repair (group A,n =86),two-stage repair using Bracka procedure (group B,n =49) and strategic urethrostomy (group C,n =30).The median age was 26 months in group A,24 months in group B and 28 months in group C.The median length of urethral defect was 3.0 (2.0-10.0) cm,4.0 (2.5-10.0) cm and 3.8(2.5-11.0) cm in the different three groups,respectively.No difference showed in age or length of urethral defect among 3 groups.Three groups were compared with rates of urethral fistula,urethral stricture and urethral diverticulum.Results After average of 20.0 months follow-up,the urethral stricture incidence of group C [3.3％ (1/30)] was significantly lower than that of group A [22.0％ (19/86),P =0.023] and group B[24.5％ (12/49),P =0.032].The complications were found in 7 patients with urethral fistula and 11 patients with urethral diverticulum in group A,4 patients with urethral fistula and 3 patients with urethral diverticulum in group B,none patient with urethral fistula nor urethral diverticulum in group C,respectively.The incidence of urethral fistula was 8.1％ (7/86),8.2％ (4/49) and 0 in the three groups,and the rate of urethral diverticulum was 12.8％ (11/86),6.1％ (3/49) and 0,respectively.None difference was shown neither in the incidence of urethral fistula nor urethral diverticulum among the three groups(P ＞ 0.05).Conclusions Strategic urethrostomy is a novel and effective method for complicated hypospadias repair.Application of strategic urethrostomy can significantly decrease urethral stricture and improve success rate in complicated hypospadias repair.
ABSTRACT
Through comparing students' achievements of one-teacher-responsible teaching and multi-teacher-responsible teaching,we found that students' achievements of one-teacher-responsible teaching were significantly higher than those of multi-teacher-responsible teaching(P