Li Changpei,Zhou Wei,Xia Fan,et al.Application of dorsal inlay urethroplasty with inner prepuce graft for hypospadias with narrow urethral plate: a clinical randomized controlled trial[J].Journal of Clinical Pediatric Surgery,,20():935-940.[doi:10.12260/lcxewkzz.2021.10.008]
Application of dorsal inlay urethroplasty with inner prepuce graft for hypospadias with narrow urethral plate: a clinical randomized controlled trial
- Keywords:
- Hypospadias/SU; Foreskin; Urethral Stricture/CO; Clinical Study
- CLC:
- R695;R695.4;R726.9
- Abstract:
- Objective To explore the efficacy of dorsal inlay urethroplasty (dorsal inlay graft urethroplasty, DIGU) with inner prepucegraft for hypospadias with narrow urethral plate.Methods A prospective study was conducted for 78 operated children with hypospadias from June 2016 to June 2018.According to different treatment methods, they were randomly divided into two groups of DIGU (n=39) and control (n=39).DIGU group underwent urethroplasty with longitudinal resection of urethral plate and dorsal urethroplasty with internal prepuce plate while control group had urethroplasty with longitudinal incision of urethral plate (tubularized incised plate, TIP).During a follow-up period of 6 months, the outcomes of penile appearance and function were observed.Operative duration, incidence of postoperative urethral stricture/diverticulum, urinary fistula, urinary flow rate (finishing toilet training) and HOSE score were recorded and compared between two groups.Results All operations were completed successfully.During an average follow-up period of 24.1 months, no significant inter-group difference existed in urethral stricture or other complications (P>0.05).Operative duration was longer in DIGU group than that in TIP group[(95.91±10.80) vs.(73.81±7.62) min, t=10.38, P<0.05].The HOSE score of DIGU group was higher than that of TIP group[(14.70±1.10) vs.(13.43±1.09), t=5.27, P<0.05].The maximal urinary flow rate (Qmax) was higher in DIGU group than that in TIP group[(9.91±1.50) vs.(6.81±1.41) ml/s, t=8.04, P<0.05].Conclusion Among children with hypospadias with a narrow urethral plate, as compared with TIP, DIGU fails to reduce the incidence of urethral stricture and operative duration is longer.However, DIGU offers a higher penile appearance score with better urination functions.Thus it may be employed as a first option for hypospadias with narrow urethral plate.
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Memo
收稿日期:2020-09-17。
基金项目:厦门市儿童医院1125人才工程资助（编号：〔2020〕6号）；厦门市儿童医院青年科研基金项目资助（编号：CHP—2019—YRF—0020）
通讯作者:周维,Email:etyy6161@126.com