요도하열 재수술 환자에서 Tubularized Incised Plate 요도성형술의 성적 및 영향 인자들
Outcome and Risk Factors of Tubularized Incised Plate Urethroplasty in Patients with Reoperative Hypospadias Repairs
하홍구, 이상돈,
소속 상세정보
하홍구 ( Ha Hong-Koo )
부산대학교 의과대학 비뇨기과학교실
이상돈 ( Lee Sang-Don )
부산대학교 의과대학 비뇨기과학교실
KMID : 0358320090500010067
Abstract
Purpose: We retrospectively evaluated the outcome and risk factors of tubularized incised plate(TIP) urethroplasty in patients with reoperative hypospadias repairs.
Materials and Methods: Thirty-nine patients with reoperative hypospadias repairs by the TIP method were evaluated. The meatal location, interval between prior urethroplasty and reoperation, length from meatus to penile tip, coexistence of chordee, type of prior urethroplasty, shape of glans, scarring on urethral plate, times of prior urethroplasty, and complications were reviewed. We also evaluated the outcome of reoperative hypospadias repairs and the relationships between these factors and outcomes.
Results: The mean age of the patients was 47.7±77.9 months(range: 5-384 months) at prior urethroplasty and 92.7±115.6 months(12-480 months) at reoperative urethroplasty, and the mean follow-up duration was 54.2±90.5 months(6-443 months). Complications at prior urethroplasty included urethrocutaneous fistula in 18 patients, wound dehiscence in 9, meatal stenosis in 5, persistent chordee in 5, and urethral diverticulum in 3. Complications at TIP reoperation were urethrocutaneous fistula and wound dehiscence in 11 and 4 patients, respectively(complication rate: 38.5%). Older age at the time of the repeat urethroplasty, long urethral defect, and scarring in the urethral plate at reoperation were related with poor outcomes in reoperative urethroplasty.
Conclusions: TIP urethroplasty for reoperative hypospadias repair can result in good cosmetic and functional outcomes. However, caution is necessary in patients of old age or with a long urethral defect and scarring at the urethral plate at reoperation.(Korean J Urol 2009;50:67-71)
키워드
Hypospadias;Reoperation;Risk factors
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