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《Journal of Applied Clinical Pediatrics》 2012-20
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Comparison on Effect of Two-Stage and One-Stage Operation on Severe Hypospadias

CHEN Jia-bo,YANG Ti-quan,WANG Shuang-quan (Department of Pediatric Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China)  
Objective To summarize the clinical experiences about severe hypospadias by analyzing the clinical characteristics and the-rapeutic effectiveness of two-stage and one-stage operation. Methods Retrospective analysis on 92 cases of severe hypospadias from Sep.2005 to Jul.2011 was performed.All patients were first operation cases,from 8 months to 23 years old,the median age was 4 years old and 8 months.There were 32 cases of two-stage operation(Snodgrass precedure),60 cases of one-stage operation(Duckett+Duplay procedure).Some projects had been compared on different procedure,such as the translocation of scrotum,the position of urinary meatus pre or post-straight,the lengths of urethral defects,the complication rate and the successful rate. Results The difference of the translocation of scrotum in the 2 groups was not statistically significant(P=0.303 9).The successful rate in the 2 groups had no statistically significant difference(P=0.796 1).The rate of scrotal post-straight in two-stage group was higher than that in one-stage group(P=0.022 8).The length of urethral defect of two-stage group was longer than that in one-stage group(P=0.000 1).The rate of urethra stenosis in one-stage group was longer than that in two-stage group(P=0.044 1). Conclusions Which operation procedure should be chosen to treat severe hypospadias,the capital principle was that the position of urinary meatus post-straight.If the lengths of urethral defects were longer than that of Duckett flap and Duplay flap,two-stage procedure should be chosen.In spite of the successful rate in the 2 groups had no difference,but the fault of operation chosen should lead to higher incidence rate of urinary fistula or urethra stenosis.
【Fund】: 广西壮族自治区卫生厅计划课题资助(桂卫Z2011330)
【CateGory Index】: R699
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