Failed hypospadias repair presenting in adults
Failed hypospadias repair presenting in adults
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DOI：
10.1016/j.eururo.2006.01.027
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发表时间：
2006-05-01
期刊：
影响因子：
23.4
通讯作者：
Lazzeri, M
中科院分区：
文献类型：
--
作者：
Barbagli, G;De Angelis, M;Lazzeri, M
目的：评价一期和多期成形术治疗成人尿道下裂术后并发症的效果。方法：对60例成人尿道下裂修补术后的并发症：狭窄34例、残留26例、尿瘘18例、尿道口狭窄11例、阴茎弯曲9例、毛发4例、憩室2例、结石1例进行手术治疗。36%的患者有一种并发症，有两种或两种以上的并发症。29例患者接受了一期颊或皮肤移植或直接修复，31例患者接受了口腔或皮肤移植的多期修复。术后随访33.8个月。在60例中，45例(75%)最终成功，15例(25%)失败。一期修复成功24例(82.7%)，失败5例(17.3%)。多阶段修复提供了21个。成功(67.7%)，失败10(32.3%)。颊粘膜移植一期手术成功率为81%，多期手术成功率为82.3%。阴茎皮肤移植在一期手术中的成功率为80%，在多阶段手术中的成功率为50%。结论：成人尿道下裂修复术后并发症仍然是一个难以治疗的人群，再次手术失败率很高。(C)2006爱思唯尔B.V.保留所有权利。
Objectives: To evaluate the results of one-stage and multistage urethroplasty in adults with complications following multiple failed hypospadias repairs.Methods: Sixty adults underwent reconstructive surgery of the following complications after hypospadias repair: stricture (34), residual hypospadias (26), fistula (18), meatal stenosis (11), penile curvature (9), hair (4), diverticula (2), and stone (1). A total of 36% of the patients had one complication and 64% had two or more complications. Twenty-nine patients underwent one-stage repair with buccal or skin grafts or direct repair, and 31 underwent multistage repairs with buccal or skin grafts.Results: Mean. follow-up was 33.8 mo. Of the 60 cases, 45 (75%) had a final successful outcome and 15 (25%) failed. One-stage repair provided 24 - (82.7%) successes and 5 (17.3%) failures. Multistage repair provided 21. (67.7%) successes and 10 (32.3%) failures. Buccal mucosa grafts provided 81% of success in one-stage procedures and 82.3% in multistage procedures. Penile skin grafts provided 80% of success in one-stage procedures and 50% in multistage procedures.Conclusions: Adults with complications following childhood hypospadias repair are still a difficult population to treat with a high failure rate for reoperative surgery. (c) 2006 Elsevier B.V. All rights reserved.