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Reoperation frequency after transverse preputial Island flap urethroplasty “Duckett’s technique” in treatment of severe hypospadias: A single center study
PURPOSE: Transverse Preputial Island Flap Urethroplasty (TPIFU) is one of the most common techniques for treating severe hypospadias. Studies on the reoperation frequency after TPIFU is lacking. In the present study, we reported our clinical outcomes of severe hypospadias treated with one-staged TPI...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9869034/ https://www.ncbi.nlm.nih.gov/pubmed/36699300 http://dx.doi.org/10.3389/fped.2022.1030649 |
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author | Li, Jiayi Liu, Pei Yang, Zhenzhen Wang, Xinyu Fan, Songqiao Li, Zonghan Song, Hongcheng Zhang, Weiping |
author_facet | Li, Jiayi Liu, Pei Yang, Zhenzhen Wang, Xinyu Fan, Songqiao Li, Zonghan Song, Hongcheng Zhang, Weiping |
author_sort | Li, Jiayi |
collection | PubMed |
description | PURPOSE: Transverse Preputial Island Flap Urethroplasty (TPIFU) is one of the most common techniques for treating severe hypospadias. Studies on the reoperation frequency after TPIFU is lacking. In the present study, we reported our clinical outcomes of severe hypospadias treated with one-staged TPIFU and analyzed the operation frequency. METHODS: We retrospectively analyzed the clinical data of severe hypospadias patients who underwent one-stage TPIFU from December 2018 to December 2019 in the department of Urology at Beijing Children's Hospital. A stepwise approach was used to manage the curvature. Severe hypospadias was defined as those residual curvature was higher than 30° after degloving. Urethroplasty complications included fistula, urethral stricture, and diverticulum. The short-term cure was identified as no complications occurring for 12 months after the date of last-time surgery. The reoperation rate and operation frequency of TPIFU were analyzed. RESULTS: A total of 136 patients who underwent one-stage TPIFU were included in the study. The follow-up after primary urethroplasty ranged from 22 to 50 months. The median age at primary surgery was 22.5 months (range from 13 to 132 months). After primary TPIFU surgery, 53 (39%) patients underwent additional surgical interventions to treat postoperative complications. Among them, 24 patients (17.6%) developed fistula, 17 patients (12.5%) developed urethral stricture and 11 patients (8.1%) developed diverticulum. After the second surgery, five patients remained fistula, five patients remained urethral stricture, and seven patients remained diverticulum. Overall, 61% (85 patients) met the cured standard after the primary operation, and the two operations cure rate was 87.5% (119 patients). 91.2% (124 patients) were cured in three operations. CONCLUSIONS: Although the complication rates after primary TPIFU were relatively high, more than half of patients achieved short-term cured through a single operation, and the cure rate after two or three operations was acceptable. |
format | Online Article Text |
id | pubmed-9869034 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98690342023-01-24 Reoperation frequency after transverse preputial Island flap urethroplasty “Duckett’s technique” in treatment of severe hypospadias: A single center study Li, Jiayi Liu, Pei Yang, Zhenzhen Wang, Xinyu Fan, Songqiao Li, Zonghan Song, Hongcheng Zhang, Weiping Front Pediatr Pediatrics PURPOSE: Transverse Preputial Island Flap Urethroplasty (TPIFU) is one of the most common techniques for treating severe hypospadias. Studies on the reoperation frequency after TPIFU is lacking. In the present study, we reported our clinical outcomes of severe hypospadias treated with one-staged TPIFU and analyzed the operation frequency. METHODS: We retrospectively analyzed the clinical data of severe hypospadias patients who underwent one-stage TPIFU from December 2018 to December 2019 in the department of Urology at Beijing Children's Hospital. A stepwise approach was used to manage the curvature. Severe hypospadias was defined as those residual curvature was higher than 30° after degloving. Urethroplasty complications included fistula, urethral stricture, and diverticulum. The short-term cure was identified as no complications occurring for 12 months after the date of last-time surgery. The reoperation rate and operation frequency of TPIFU were analyzed. RESULTS: A total of 136 patients who underwent one-stage TPIFU were included in the study. The follow-up after primary urethroplasty ranged from 22 to 50 months. The median age at primary surgery was 22.5 months (range from 13 to 132 months). After primary TPIFU surgery, 53 (39%) patients underwent additional surgical interventions to treat postoperative complications. Among them, 24 patients (17.6%) developed fistula, 17 patients (12.5%) developed urethral stricture and 11 patients (8.1%) developed diverticulum. After the second surgery, five patients remained fistula, five patients remained urethral stricture, and seven patients remained diverticulum. Overall, 61% (85 patients) met the cured standard after the primary operation, and the two operations cure rate was 87.5% (119 patients). 91.2% (124 patients) were cured in three operations. CONCLUSIONS: Although the complication rates after primary TPIFU were relatively high, more than half of patients achieved short-term cured through a single operation, and the cure rate after two or three operations was acceptable. Frontiers Media S.A. 2023-01-09 /pmc/articles/PMC9869034/ /pubmed/36699300 http://dx.doi.org/10.3389/fped.2022.1030649 Text en © 2023 Li, Liu, Yang, Wang, Fan, Li, Song and Zhang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Li, Jiayi Liu, Pei Yang, Zhenzhen Wang, Xinyu Fan, Songqiao Li, Zonghan Song, Hongcheng Zhang, Weiping Reoperation frequency after transverse preputial Island flap urethroplasty “Duckett’s technique” in treatment of severe hypospadias: A single center study |
title | Reoperation frequency after transverse preputial Island flap urethroplasty “Duckett’s technique” in treatment of severe hypospadias: A single center study |
title_full | Reoperation frequency after transverse preputial Island flap urethroplasty “Duckett’s technique” in treatment of severe hypospadias: A single center study |
title_fullStr | Reoperation frequency after transverse preputial Island flap urethroplasty “Duckett’s technique” in treatment of severe hypospadias: A single center study |
title_full_unstemmed | Reoperation frequency after transverse preputial Island flap urethroplasty “Duckett’s technique” in treatment of severe hypospadias: A single center study |
title_short | Reoperation frequency after transverse preputial Island flap urethroplasty “Duckett’s technique” in treatment of severe hypospadias: A single center study |
title_sort | reoperation frequency after transverse preputial island flap urethroplasty “duckett’s technique” in treatment of severe hypospadias: a single center study |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9869034/ https://www.ncbi.nlm.nih.gov/pubmed/36699300 http://dx.doi.org/10.3389/fped.2022.1030649 |
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