Zeng Li,Zhang Zhibo,Gu Fei,et al.Covering technique of ventral Dartos flap during tubularized incised plate urethroplasty for hypospadias and observation of curative efficacy[J].Journal of Clinical Pediatric Surgery,,20():1031-1037.[doi:10.12260/lcxewkzz.2021.11.007]
Covering technique of ventral Dartos flap during tubularized incised plate urethroplasty for hypospadias and observation of curative efficacy
- CLC:
- R726.9;R726.1;R619
- Abstract:
- Objective To explore the feasibility and efficacy of covering technique of ventral Dartos flap duing tubularized incised plate (TIP) urethroplasty for distal hypospadias and midshaft hypospadias in boys. Methods From March 2018 to March 2020, retrospective analysis was performed for 50 consecutive boys with hypospadias surgically corrected by the same experienced pediatric urologist. They were randomly divided into two groups. Group A:26 boys underwent modified TIP urethroplasty using a covering technique of ventral Dartos flap of penis. The average age was 29.8 months. Urethral defect had an average length of 1.74(1.0-2.5) cm while urethral plate an average width of 9.12 mm. The average width of glans was 13.08(12-15) mm. Group B:24 boys underwent modified TIP urethroplasty using a covering technique of ventral Buck’s fascia flap of penis. The average age was 29.6 months. Urethral defect had an average length of 1.63(1.0-2.5) cm while urethral plate an average width of 8.92 mm. The average width of glans was 13.00(12-15) mm. The incidence of urethral fistula was compared after hypospadias repairing. And the efficacies were evaluated by the HOSE scheme at Month 3 post-operation. Results During a follow-up period of (6-25) months, urethral fistula occurred in group A (n=3, 11.5%) and group B (n=6, 16.7%). No statistically significant difference existed in the incidence of urethral fistula (χ2=0.273, P=0.601). There was no instance of urethral stricture, urethral diverticulum or recurrent ventral curvature (>30°). The HOSE score of group A was 14.92±0.89 and that of group B was (14.83±1.133) at Month 3 post-operation. There was no statistically significant inter-group difference (t=0.313, P=0.755). Conclusion Ventral Dartos flap of penis may be easily harvested with an excellent extension and a uniform thickness. The new technique of covering technique of ventral vertical flip fascia of penis for distal penile hypospadias or midshaft hypospadias is simple, feasible and efficacious during TIP urethroplasty.
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Memo
收稿日期:2021-01-25。
基金项目:四川省科技厅重点研发项目（编号：2021YFS0244）
通讯作者:黄鲁刚,Email:lugang992001@163.com