Fang Yiwei,Song Hongcheng,Sun Ning,et al.Application of tubularized incised urethral plate urethroplasty for hypospadias and its long-term follow-ups[J].Journal of Clinical Pediatric Surgery,,19():1082-1087.[doi:10.3969/j.issn.1671-6353.2020.12.005]
Application of tubularized incised urethral plate urethroplasty for hypospadias and its long-term follow-ups
- CLC:
- R726.9;R697+.11;R695
- Abstract:
- Objective To review retrospectively the penile characteristics of hypospadias in children after tubularized incised plate (TIP) urethroplasty and summarize the indications of TIP so as to understand its long-term urination,sexual function and psychosocial status.Methods Clinical data were reviewed for 266 children undergoing initial and repeated TIP for hypospadias from January 2004 to December 2011.A pre-designed questionnaire of basic profiles after TIP was utilized along with a HOSE scoring system for examining long-term postoperative efficacy through telephone follow-ups and out-patient reviews.Results Among 2993 children undergoing urethroplasty during the same period,a total of 266 children (8.89%) fulfilled the inclusion criteria.The average operative age of TIP was 67(12-201) months.The conditions of penis were no obvious preoperative penile curvature (n=74),mild penile curvature corrected by foreskin degloving and released of ventral fibrous tissue (n=106) and moderate penile penile curvature corrected by dorsal placation (n=86).The width of urethral plate was approximately 0.6-1.0 cm with rich blood supply and excellent elasticity.And the width was around 1.0-1.4 cm after longitudinal incision.Follow-ups were conducted for 113 cases (42.5%) and 153 cases became lost to follow-ups.The mean follow-up period was 12.5 years and the mean age at the last follow-up 214 months.And they were satisfactory penile appearance (83.2%),urination dysfunctions (20.3%) and recurrent ventral curvature (6.2%).None of them had penile erectile dysfunction or painful erection and 98.2% achieved excellent psychosocial adjustments.Conclusion The strict indications of TIP should be grasped for distal and intermediate types of hypospadias with no severe penile curvature and decent development of urethral plate.Based upon correctly grasping the indications,children may obtain better long-term outcomes of appearance,urination and sexual function.
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Memo
收稿日期:2020-07-16。
基金项目:国家重点研发计划（编号：2016YFC1000807）
通讯作者:宋宏程,Email:songhch1975@126.com