Urethroplasty by Use of Turnover Flaps (Modified Mathieu Procedure) for Distal Hypospadias Repair in Adolescents: Comparison With the Tubularized Incised Plate Procedure
배성호, 이준녕, 김현태, 정성광,
소속 상세정보
배성호 ( Bae Seong-Ho )
Kyungpook National University School of Medicine Department of Urology
이준녕 ( Lee Jun-Nyung )
Kyungpook National University School of Medicine Department of Urology
김현태 ( Kim Hyun-Tae )
Kyungpook National University School of Medicine Department of Urology
정성광 ( Chung Sung-Kwang )
Kyungpook National University School of Medicine Department of Urology
KMID : 0358320140550110750
Abstract
Purpose: The purpose of this study was to examine whether urethroplasty with a turnover flap, as an alternative method of distal hypospadias repair in adolescents, improves the outcome of surgery.
Materials and Methods: Between January 2004 and December 2013, a total of 38 adolescents (aged 11-17 years) underwent distal hypospadias repair with either the tubularized incised plate (TIP) procedure (n=25) or the turnover flap procedure (n=13). The turnover flap procedure was performed with a proximal, ventral penile flap that was turned over to cover the urethral plate. Patient demographics, perioperative outcomes, complications, and postoperative uroflowmetry in each surgical group were analyzed retrospectively.
Results: The patient demographics were similar in the two groups. There were no significant differences in perioperative outcomes between the groups, including mean operative time, duration of hospital stay, and urethral catheterization. The number of patients with at least one complication, including wound dehiscence, urethrocutaneous fistula, meatal stenosis, and urethral stricture, was lower in the turnover flap group (1/13, 7.7%) than in the TIP group (11/25, 44%, p=0.030). The incidence of meatal stenosis was lower in the turnover flap group (0/12, 0%) than in the TIP group (6/25, 24%). In postoperative uroflowmetry, the plateau-shaped curve rate was lower in the turnover flap group (1/12, 8.3%) than in the TIP group (5/19, 26.3%); the peak flow was higher (p=0.030).
Conclusions: The turnover flap procedure is clinically useful for repairing adolescent distal hypospadias because it offers lower complication rates and better functional outcomes than TIP.
키워드
Adolescent; Complications; Hypospadias
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