Urinary function after Snodgrass repair of distal hypospadias: comparison with the Mathieu repair
Urinary function after Snodgrass repair of distal hypospadias: comparison with the Mathieu repair
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DOI：
10.1007/s00383-010-2569-6
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发表时间：
2010-05-01
影响因子：
1.8
通讯作者：
Musi, Luciano
中科院分区：
文献类型：
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作者：
Scarpa, Maria Grazia;Castagnetti, Marco;Musi, Luciano
目的评价管状切开钢板尿道成形术治疗远端型尿道下裂患者的排尿功能（TIP或Septum grass），将结果与Mathieu技术治疗的患者的结果进行比较，并显示评价此类结果的潜在问题。对3年期间手术的无并发症远端尿道下裂进行横断面评估，这些患者已经接受过如厕训练，并且能够自愿地放空评估包括临床评估泌尿系统症状和尿流，以及尿流率。在研究期间进行手术的83例患者中，10例（12%）发生并发症，32例未接受如厕训练或拒绝参加研究。研究中其余41例患者的中位随访时间为20（3-36）个月。这些患者均未出现排尿症状或尿流异常。尿流率正常30例，梗阻性11例（27%）。在接受TIP与Mathieu修复术的患者中，阻塞性血流模式更常见，分别为8/19（42%）与3/22（14%）（P = 0.07）。4例TIP合并梗阻性尿流的病例采用保守治疗，尽管TIP和Mathieu修复术在远端尿道下裂修复后的排尿功能方面都有良好的效果，但TIP技术似乎更可能与尿流异常有关。这一发现的实际临床意义仍不明确。
To evaluate urinary function in patients with distal hypospadias undergoing repair by the tubularized incised-plate urethroplasty (TIP or Snodgrass), compare the results with those in patients treated by the Mathieu technique, and show the potential issues inherent to the evaluation of such results.A cross-sectional assessment was performed of uncomplicated distal hypospadias operated on during a 3-year period, already toilet trained, and able to void volitionally. Evaluation included clinical assessment urinary symptoms and urinary stream, and uroflowmetry.Out of 83 patients operated on during the study period, 10 (12%) developed complication and 32 were not toilet trained or refused to participate in the study. Median follow-up in the remaining 41 patients included in the study was 20 (3-36) months. None of these patients presented voiding symptoms or urinary stream abnormalities. Uroflowmetry was normal in 30 cases and obstructive in 11 (27%). An obstructive flow pattern was more common in patients undergoing TIP versus Mathieu repair, 8 of 19 (42%) versus 3 of 22 (14%), respectively (P = 0.07). Four TIP cases with an obstructive uroflow pattern were managed conservatively.Although both the TIP and the Mathieu repair allow good results in terms of urinary function after distal hypospadias repairs, the TIP technique seems more likely to be associated with urine flow pattern abnormalities. The actual clinical relevance of this finding remains ill defined.