Onlay-tube-onlay urethroplasty used for one-stage repairing of severe hypospadias / 中华泌尿外科杂志

ABSTRACT

Objective To retrospectively analyze the efficacy of Onlay-tube-onlay urethroplasty used for one-stage repairing of severe hypospadias.Methods From May 2012 to October 2014, a total of 32 patients with severe hypospadias who underwent primary HR at Nanjing Medical University Affiliated Children Hospital were enrolled.Urethral opening was located in the penis and scrotum, and onlay-tube-onlay urethroplasty was performed in the patients who had severe penile curvature even after skin degloving. The average age was 2.8 years (7 months-13 years and 7 months), postoperative follow-up was 2 years and 1month on average ( 6 months -2 years and 11 months ), and clinical data including appearance, complications and uroflowmetry were documented.Results All of 32 surgeries were completed by one experienced pediatric urologist, and the urethral defect length was measured after penile curvature completely corrected.The postoperative complications included two cases of urinary fistula ( 6.25%) and 3 cases of urethral stricture (9.37%).Two cases of fistula were cured by one operation.Stricture of urethral external orifice was relieved after urethral dilation in 1 case, and another 2 cases underwent another operation.The straightening and appearance of penis were satisfactory and meatus was located at normal anatomical position postoperatively.Uroflow was shaped into bell or high platform.Conclusions Onlay-tube-onlay urethroplasty is a combination of Onlay and Duckeet surgery, with low complication rates.Fully stripping and preserving urethral plate decrease the occurrence of complications, especially stricture. Urethral plate transecting permitted penile straightening completely.Onlay-tube-onlay can be a good option for the patients with severe hypospadias.