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【Objective】 To investigate the effects of lamellar surgical techniques with urethral plate to strengthen the tissue of glans penis to widen the two flanks of glans penis on the basis of Duckett method in the treatment of congenital hypospadias with small glans penis deformity. 【Methods】 A total of 22 patients admitted to our hospital during Jun.2017 and Oct.2020 were involved. Urethral plate was used to replace the glans penis tissue to widen the two flanks of glans penis based on Duckett method. Lamellar surgical techniques were adopted to fully dissociate the two flanks of glans penis and urethral plate for urethroplasty. 【Results】 Of the 22 operations, 19 were successful,with a success rate of 86.3%. The success rate of penile head urethroplasty reached 96.1%. 【Conclusion】 Widening the glans penis by using the urethral plate based on Duckett method combined with lamellar surgical techniques can improve the success rate of glans penis urethroplasty.
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Objective To explore the effect of reducing complication in branched spongiosum repair for hypospadias Duckett surgery.Methods Retrospective 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.Results There 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).Conclusions Urethral cavernosum reconstruction can significantly reduce the incidence of postoperative coronary groove fistula of hypospadias Duckett surgery and improve the postoperative urine flow rate.
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Objective@#To explore the effect of reducing complication in branched spongiosum repair for hypospadias Duckett surgery.@*Methods@#Retrospective 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.@*Results@#There 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).@*Conclusions@#Urethral cavernosum reconstruction can significantly reduce the incidence of postoperative coronary groove fistula of hypospadias Duckett surgery and improve the postoperative urine flow rate.
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A review was presented in 4 cases of one-stage Duckett's method for hypospadia which was experienced in our hospital. Of 4 cases, 1 case was successed by only Duckett's method and 3 cases needed 2nd operation. But, it was emphasized that the island flap one-stage hypospadias technique was worth trying and the addition of skill in technique would satisfactory results.
Asunto(s)
Femenino , Masculino , HipospadiasRESUMEN
A review was presented in 4 cases of one-stage Duckett's method for hypospadia which was experienced in our hospital. Of 4 cases, 1 case was successed by only Duckett's method and 3 cases needed 2nd operation. But, it was emphasized that the island flap one-stage hypospadias technique was worth trying and the addition of skill in technique would satisfactory results.