Comparison of continuous eversion and inverting subepithelial suture in transverse preputial island flap urethroplasty in proximal hypospadias repair: A retrospective study

ABSTRACT Introduction: Transverse preputial island flap urethroplasty (TPIFU) is one of the most frequently performed technique for single-stage repair in proximal hypospadias. It was reported that the subepithelial urethroplasty would obviously decrease urethrocutaneous fistula (UF) complication after proximal TIP. But in the process of TPIFU, it had not been reported yet. Objective: We reviewed our experience to evaluate and compare the effect of continuous eversion suture (CES) versus continuous inversion subepithelial suture (CIS) on complication rates in the TPIFU. Material and methods: A retrospective review of all patients operated with CES and CIS in our institution between January 2017 and Jun 2017 was performed. Results: A total of 161 patients were enrolled in the research. Patients were followed up for 12~17 months. Total success rate was 73.9% (119/161). No statistically difference was found between the two groups with regard to age of patients (P=0.097), catheter size (P=0.52), time of catheterization (P=0.47), length of neourethra (P=0.20), non-urethral comorbidity (P=0.44) and post-operative infection (P=1.0). The overall postoperative complications had no statistically difference between the two groups (P=0.067). There were no statistically significant differences in the incidence of urethra-cutaneous fistula (UF) (OR=0.07, 95% CI: -0.24~0.037, P=0.22), urethral diverticulum (UD) (OR=0.026, 95% CI: -0.16~-0.056, P=0.323), urethral stricture (US) (OR=0.081, 95% CI: -0.15~0.15, P=1.0) and breakdown of urethral repair (BU) (OR=0.02, 95% CI: -0.118~-0.044, P=1.0). Discussion: The comparison of two group's postoperative complications was feasible because there were no statistically differences among perioperative variables. It seemed as if continuous inversion subepithelial suture would promote healing. However, it indicated that the overall success rate and the incidences of UF, UD, US and BU complications had no statistically difference between groups. It might be accounted for the subtle differences of techniques changing the process of establishing prime and side branches vascularization. Conclusions: The CIS technique had no significantly different effect on the four complications rates when compared with CES in TPIFU. Thus, CES and CIS could be randomly adopted in TPIFU as personal preference.

Comparison of continuous eversion and inverting subepithelial suture in transverse preputial island flap urethroplasty in proximal hypospadias repair: A retrospective study.

INTRODUCTION: Transverse preputial island flap urethroplasty (TPIFU) is one of the most frequently performed technique for single-stage repair in proximal hypospadias. It was reported that the subepithelial urethroplasty would obviously decrease urethrocutaneous fistula (UF) complication after proximal TIP. But in the process of TPIFU, it had not been reported yet. OBJECTIVE: We reviewed our experience to evaluate and compare the effect of continuous eversion suture (CES) versus continuous inversion subepithelial suture (CIS) on complication rates in the TPIFU. MATERIAL AND METHODS: A retrospective review of all patients operated with CES and CIS in our institution between January 2017 and Jun 2017 was performed. RESULTS: A total of 161 patients were enrolled in the research. Patients were followed up for 12~17 months. Total success rate was 73.9% (119/161). No statistically difference was found between the two groups with regard to age of patients (P=0.097), catheter size (P=0.52), time of catheterization (P=0.47), length of neourethra (P=0.20), non-urethral comorbidity (P=0.44) and post-operative infection (P=1.0). The overall postoperative complications had no statistically difference between the two groups (P=0.067). There were no statistically significant differences in the incidence of urethra-cutaneous fistula (UF) (OR=0.07, 95% CI: -0.24~0.037, P=0.22), urethral diverticulum (UD) (OR=0.026, 95% CI: -0.16~-0.056, P=0.323), urethral stricture (US) (OR=0.081, 95% CI: -0.15~0.15, P=1.0) and breakdown of urethral repair (BU) (OR=0.02, 95% CI: -0.118~-0.044, P=1.0). DISCUSSION: The comparison of two group's postoperative complications was feasible because there were no statistically differences among perioperative variables. It seemed as if continuous inversion subepithelial suture would promote healing. However, it indicated that the overall success rate and the incidences of UF, UD, US and BU complications had no statistically difference between groups. It might be accounted for the subtle differences of techniques changing the process of establishing prime and side branches vascularization. CONCLUSIONS: The CIS technique had no significantly different effect on the four complications rates when compared with CES in TPIFU. Thus, CES and CIS could be randomly adopted in TPIFU as personal preference.

Embryonic and larval development of the topmouth gudgeon, Pseudorasbora parva (Teleostei: Cyprinidae)

The topmouth gudgeon, Pseudorasbora parva (Temminck & Schlegel, 1842), is a small cyprinid fish that inhabits the littoral zones of freshwater habitats throughout Asia and Europe. It is regarded as an invasive species in Europe, but in its native range, in China, as food and as an environmental bio-indicator. In this study, the embryonic and larval development of P. parva was investigated for the first time. The eggs of P. parva are transparent, adhesive and elliptical. The mean size of fertilized eggs was (1.63×1.31) ± 0.04 mm. From fertilization to hatching, embryonic development could be divided into eight stages and 34 phases, and the incubation period lasted for 109.25 hours at 24 ± 1 °C. Newly hatched larvae were 4.1 ± 3 mm in length, and the yolk absorption was completed within six days after hatching. The first and second swim bladders formed at the third and ninth day, respectively. The pectoral fin formed before the hatching stage, followed by the caudal, dorsal, anal and ventral fin formation after hatching. About 20 days after hatching, the morphology of the fry was similar to the adult fish. These findings provide a basis for determining the complete ontogeny of P. parva, as well as facilitate the management and utilization of this fish.(AU)

Embryonic and larval development of the topmouth gudgeon, Pseudorasbora parva (Teleostei: Cyprinidae)

The topmouth gudgeon, Pseudorasbora parva (Temminck & Schlegel, 1842), is a small cyprinid fish that inhabits the littoral zones of freshwater habitats throughout Asia and Europe. It is regarded as an invasive species in Europe, but in its native range, in China, as food and as an environmental bio-indicator. In this study, the embryonic and larval development of P. parva was investigated for the first time. The eggs of P. parva are transparent, adhesive and elliptical. The mean size of fertilized eggs was (1.63×1.31) ± 0.04 mm. From fertilization to hatching, embryonic development could be divided into eight stages and 34 phases, and the incubation period lasted for 109.25 hours at 24 ± 1 °C. Newly hatched larvae were 4.1 ± 3 mm in length, and the yolk absorption was completed within six days after hatching. The first and second swim bladders formed at the third and ninth day, respectively. The pectoral fin formed before the hatching stage, followed by the caudal, dorsal, anal and ventral fin formation after hatching. About 20 days after hatching, the morphology of the fry was similar to the adult fish. These findings provide a basis for determining the complete ontogeny of P. parva, as well as facilitate the management and utilization of this fish.