Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Distal Hipospadias Cerrahisinde Flep Sayısının Prognoza Etkisi: Retrospektif Kesitsel Bir Çalışma
The Effect of Flap Number on Prognosis in Distal Hypospadias Surgery: A Retrospective Cross-sectional Study
Veli AVCIa, Murat DEMİRb
aVan Yüzüncü Yıl Üniversitesi Dursun Odabaş Tıp Merkezi, Çocuk Cerrahisi Kliniği, Van, TÜRKİYE
bVan Yüzüncü Yıl Üniversitesi Dursun Odabaş Tıp Merkezi, Üroloji Kliniği, Van, TÜRKİYE
J Reconstr Urol. 2021;11(2):68-72
doi: 10.5336/urology.2021-81497
Article Language: TR
Full Text
ÖZET
 Amaç: Hipospadias onarımlarında flep uygulamaları sıkça kullanılan bir yöntemdir. Bu çalışmada, hipospadias cerrahisinde tek veya çift flep kullanımının prognoza etkisini araştırdık. Gereç ve Yöntemler: Çalışmamızda, 2014 ile 2020 yılları arasında 2 merkezde (Van Yüzüncü Yıl Üniversitesi Çocuk Cerrahisi Kliniği ile Bingöl Kadın Doğum ve Çocuk Hastalıkları Hastanesi Çocuk Cerrahisi Kliniği) tek cer rah tarafından Snodgrass yöntemi ile yapılan distal hipospadias vakaları retrospektif olarak değerlendirildi Sütür hattını desteklemek için kullanılan flep sayısına göre tek ve çift şeklinde 2 gruba ayrıldı. Her 2 grup darlık, fistül, enfeksiyon, ödem ve kanama açısından karşılaştırıldı. Bulgular: Çalışmaya dâhil edilen 40 hastanın yaş ortalaması 3,9±3,2 yıl idi. Bu hastaların 25'inde tek flep, 15'inde çift flep kullanıldığı görüldü. Tek flep kullanılan hastaların 3'ünde (%12) fistül geliştiği gözlenirken, çift flep kullanılan hastaların hiçbirinde fistül gelişmediği görüldü. Darlık, enfeksiyon, ödem ve kanama açısından ise gruplar arasında farklılık yok idi. Sonuç: Distal hipospadias cerrahisinde çift flep kullanımı fistül oranını azaltırken, diğer komplikasyonlar açısından farklılık göstermemektedir.

Anahtar Kelimeler: Flep; distal hipospadias; prognoz
ABSTRACT
 Objective: Flap applications are frequently used method in hypospadias repairs. In this study, we investigated the effect of using single or double flaps in hypospadias surgery on prognosis. Material and Methods: In our study, cases of distal hypospadias performed with Snodgrass method by a single surgeon in two centers (Van Yuzuncu Yil University Pediatric Surgery Clinic and Bingol Maternity and Children's Hospital Pediatric Surgery Clinic) between 2014 and 2020 were evaluated retrospectively They were divided into two groups as single and double according to the number of flaps used to support the suture line. Both groups were compared in terms of stenosis, fistula, infection, edema and bleeding. Results: The mean age of 40 patients included in the study was 3.9±3.2 years. It was observed that single flap was used in 25 of these patients and double flaps were used in 15 of them. It was observed that fistula developed in three (12%) patients in which a single flap was used, while no fistula developed in any of the patients in whom double flaps were used. There was no difference between the groups in terms of stenosis, infection, edema and bleeding. Conclusion: While the use of double flaps in distal hypospadias surgery decreases the rate of fistula, it does not differ in terms of other complications.

Keywords: Flap; distal hypospadias; prognosis
REFERENCES:
  1. Baskin LS. Hypospadias. In: Grosfeld JL, O'NeillJ, Coran A, Fonkalsrud E, eds. Pediatr Surgery. 6th ed. Philadelphia: Mosby Elsevier; 2006. p.1870-98. [Crossref] 
  2. Mouriquand PD, Persad R, Sharma S. Hypospadias repair: current principles and procedures. Br J Urol. 1995;76 Suppl 3:9-22. [Crossref]  [PubMed] 
  3. Hinman F. Atlas of pediatric urologic surgery. In: Bracka A, Hodgson NB, Keating MA, Koff SA, Redman JF, Smith ED, eds. Penis, urethra, and genitalia. Philadelphia: WB Saunders; 1994. p.651-870. [Link] 
  4. Snodgrass W, Koyle M, Manzoni G, Hurwitz R, Caldamone A, Ehrlich R. Tubularized incised plate hypospadias repair for proximal hypospadias. J Urol. 1998;159(6):2129-31. [Crossref]  [PubMed] 
  5. Söylemez H, Burgu B. Hipospadias onarı mında başarıyı etkileyen faktörler üzerine bir derleme [A review on factors in the success of hypospadias repair]. Türkiye Klinikleri J Nephrol. 2009;4(2):62-73. [Link] 
  6. Borer JG, Bauer SB, Peters CA, Diamond DA, Atala A, Cilento BG Jr, et al. Tubularized incised plate urethroplasty: expanded use in primary and repeat surgery for hypospadias. J Urol. 2001;165(2):581-5. [Crossref]  [PubMed] 
  7. Cheng EY, Vemulapalli SN, Kropp BP, Pope JC 4th, Furness PD 3rd, Kaplan WE, et al. Snodgrass hypospadias repair with vascularized dartos flap: the perfect repair for virgin cases of hypospadias? J Urol. 2002;168(4 Pt 2):1723-6 discussion 1726. [Crossref]  [PubMed] 
  8. Balkan E, Kılıç N, Kırkpınar A, Doğruyol H Hipospadias onarımında Snodgrass yönteminin başarısını etkileyen faktörler [Factors effecting success of Snodgrass technique in hypospadias repair]. Uludağ Üniv Tıp Fak Derg. 2003;29(3):35-7. [Link] 
  9. Kraft KH, Shukla AR, Canning DA. Hypospadias. Urol Clin North Am. 2010;37(2):167-81. [Crossref]  [PubMed] 
  10. Atan A, Aslan Y, Tuncel A, Yıldız M, Balcı M, Bilgin Ö. Primer ve nüks hipospadiyas olgularında tüblarize insize plak retroplastisi sonuçlarımız [Our results of tubularized incised plate urethroplasty in cases with primer and recurrent hipospadias]. Turkish J of Urol. 2011;37(2):136-41. [Link] 
  11. Sozubir S, Snodgrass W. A new algorithm for primary hypospadias repair based on tip urethroplasty. J Pediatr Surg. 2003;38(8):1157-61. [Crossref]  [PubMed] 
  12. El-Sherbiny MT, Hafez AT, Dawaba MS, Shorrab AA, Bazeed MA. Comprehensive analysis of tubularized incised-plate urethroplasty in primary and re-operative hypospadias. BJU Int. 2004;93(7):1057-61. [Crossref]  [PubMed] 
  13. Holland AJ, Smith GH. Effect of the depth and width of the urethral plate on tubularized incised plate urethroplasty. J Urol. 2000;164(2): 489-91. [Crossref]  [PubMed] 
  14. Elbakry A. Tubularized-incised urethral plate urethroplasty: is regular dilatation necessary for success? BJU Int. 1999;84(6):683-8. [Crossref]  [PubMed] 
  15. Zeytun H, Yiğiter M, Salman A. Hipospadias tedavisinde uygulanan cerrahi tekniklerin retrospektif karşılaştırılması [Retrospective comparison of surgical techniques used in the hypospadias treatment]. Dicle Tıp Derg. 2013;40(2):269-74. [Crossref] 
  16. Karacaoğlan N, Velidedeoğlu H, Çiçekci B, Şahin Ü, Bozdağan N, Türkgüven Y. Vaskülarize prerüsyal ada flep yöntemi ile penil hipospadias onarımı [Repair of penil hypospadias with vascularized preputial island flap]. Deneysel ve Klinik Tıp Derg. 2010;9(2):93-6. [Link] 

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