Hypospadias repair in adults: Adventures and misadventures
Hypospadias repair in adults: Adventures and misadventures
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DOI：
10.1097/00005392-200101000-00019
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发表时间：
2001-01-01
影响因子：
6.6
通讯作者：
Pollard, J
中科院分区：
文献类型：
--
作者：
Hensle, TW;Tennenbaum, SY;Pollard, J
目的：为了评估长期结果和并发症，我们回顾了42例18至47岁的连续男性患者的记录1979年至1999年期间，对10例尿道下裂患者进行了尿道下裂修补术，平均年龄22.5岁。研究人群被分为第1组，包括8例既往未接受尿道下裂手术的患者，2例为12例在儿童时期接受过1次或多次手术，但局部组织相对完整; 3例为22例多次尿道下裂手术失败，但有不同程度的阴茎畸形和局部组织缺损。第I组至第3组8例患者中有3例（37.5%）、12例患者中有5例（41.67%）和22例患者中有14例（63.6%）出现并发症，分别包括3例（100%）、4例（80%）和10例（71.4%），其中二次手术长期成功。第2组1例患者和第3组2例患者等待进一步手术，而第3组2例患者失访。42名男性中有22名（52.3%）发生了总体原发性并发症，22名男性中有5名（22.7%）发生了继发性并发症。42例中有37例（88.1%）长期成功。结论：成人尿道下裂修复的结果与儿童类似手术的结果不同。虽然各种技术相似，但在伤口愈合、感染、并发症发生率和总体成功率方面存在明显差异。接受尿道下裂修复术的成人必须就所有这些变量进行咨询，以避免不合理的期望。
Purpose: To evaluate long-term results and complications we reviewed the records of 42 consecutive men 18 to 47 years old (mean age 22.5) who underwent hypospadias repair between 1979 and 1999.Materials and Methods: The study population was divided into groups 1 consisting of 8 patients without previous hypospadias surgery, 2 consisting of 12 who underwent 1 or more procedures in childhood but in whom local tissue was relatively intact and 3 consisting of 22 who underwent multiple unsuccessful hypospadias repairs with various degrees of penile deformity and loss of local tissue.Results: Complications were noted in 3 of 8 (37.5%), 5 of 12 (41.67%) and 14 of 22 (63.6%) patients in groups I to 3, including 3 (100%), 4 (80%) and 10 (71.4%), respectively, in whom secondary surgery was successful in the long term. A patient in group 2 and 2 in group 3 await further surgery, while 2 in group 3 were lost to followup. Overall primary complications developed in 22 of the 42 men (52.3%) and 5 of the 22 (22.7%) had secondary complications. There was long-term success in 37 of 42 cases (88.1%).Conclusions: The results of hypospadias repair in adulthood differ from the results of similar procedures in childhood. Although the various techniques are similar, there is clearly a difference in terms of wound healing, infection, complication rates and overall success. Adults undergoing hypospadias repair must be counseled on all of these variables to avoid unreasonable expectations.