Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Efficacy of Single-Stage Surgery (Island Tube Hypospadias Repair) in the Treatment of Proximal Hypospadias: A Comparative Retrospective Study
Proksimal Hipospadias Tedavisinde Tek Aşamalı Cerrahinin (Ada Tüp Hipospadias Onarımı) Etkinliği: Karşılaştırmalı Retrospektif Bir Çalışma
Kenan YALÇINa , Engin KÖLÜKÇÜa , Fatih FIRATa , Yunus Emre KUYUCUb
aTokat Gaziosmanpaşa University Faculty of Medicine, Department of Urology, Tokat, Türkiye
bTokat Gaziosmanpaşa University Faculty of Medicine, Department of Biostatistics, Tokat, Türkiye
J Reconstr Urol. 2024;14(2):59-65
doi: 10.5336/urology.2024-104541
Article Language: EN
Full Text
ABSTRACT
 Objective: The complexity of hypospadias surgery and the risk of complications increase as the location of the opening moves proximally. In some cases, single-session surgical techniques are sufficient, whereas in others, complementary surgical techniques performed at different times are required. In this study, we aimed to evaluate the efficacy of single-stage surgery [island tube hypospadias repair (ITHR)] in the treatment of proximal hypospadias through a comparative retrospective analysis. Material and Methods: The data of 139 patients who underwent surgery for proximal hypospadias between 2011-2020 in our pratice were analyzed retrospectively. A total of 76 patients underwent ITHR and 63 patients underwent two-stage hypospadias surgery (TSHS). All operated patients were followed up for 2 years to detect urethrocutaneous fistula, urethral stenosis, meatal stenosis, urethral diverticulum development, tissue dehiscence (wound dehiscence), residual chordee, and final cosmetic appearance. Results: The median (25.p-75.p) age and operative time of 76 patients who underwent ITHR were 3 (2-4) years and 179 (166.5-195) minutes. The median (25.p-75.p) ages and operative times of 63 patients who underwent TSHS were 4 (3-5) years and 220 (198-245) minutes. Although the median ages were similar, the operative time was longer in TSHS (p<0.05). Complications and final cosmetic appearance were similar in ITHR and TSHS cases (p>0.05). Conclusion: ITHR was found to be an effective technique in the treatment of proximal hypospadias, with complication rates similar to TSHS. The important advantages of ITHR are that it requires only one anesthesia, has shorter operation times, and relieves the burden on families.

Keywords: One-stage surgery; hypospadias; proximal; island tube; two-stage surgery
ÖZET
 Amaç: Hipospadias cerrahisinin karmaşıklığı ve komplikasyon riski açıklığın yeri, proksimale doğru ilerledikçe artmaktadır. Bazı durumlarda, tek seanslık cerrahi teknikler yeterli olurken bazı durumlarda ise farklı zamanlarda yapılan tamamlayıcı cerrahi tekniklere ihtiyaç duyulur. Bu çalışmada, proksimal hipospadias tedavisinde tek aşamalı cerrahinin [ada tüp hipospadias onarımı (island tube hypospadias repair ''ITHR'')] etkinliğini karşılaştırmalı retrospektif analizle değerlendirmeyi amaçladık. Gereç ve Yöntemler: Pratiğimizde 2011-2020 yılları arasında proksimal hipospadias nedeniyle ameliyat edilen 139 hastanın verileri, retrospektif olarak incelendi. Toplam 76 hastaya ITHR, 63 hastaya ise iki aşamalı hipospadias ameliyatı [two-stage hypospadias surgery (TSHS)] uygulandı. Ameliyat edilen tüm hastalar; üretrokutanöz fistül, üretral stenoz, mea stenozu, üretral divertikül gelişimi, doku ayrılması (yara açılması), rezidüel kordi ve son kozmetik görünüm açısından 2 yıl boyunca takip edildi. Bulgular: ITHR uygulanan 76 hastanın yaşları ve ameliyat süresi, median (25.p-75.p) olarak 3 (2-4) yıl ve 179 (166.5-195) dk idi. TSHS uygulanan 63 hastanın yaşları ve ameliyat süresi, median (25.p-75.p) olarak 4 (3-5) yıl ve 220 (198-245) dk'dır. Yaşların ortancaları benzer olmakla birlikte, TSHS'de ameliyat süresi daha uzundu (p<0,05). ITHR ve TSHS olgularında komplikasyonlar ve son kozmetik görünüm benzerdi (p>0,05). Sonuç: ITHR'nin proksimal hipospadias tedavisinde TSHS'ye benzer komplikasyon oranlarıyla etkili bir teknik olduğu ortaya konulmuştur. Tek anestezi gerektirmesi, ameliyat süresinin kısa olması ve ailelerin yükünü hafifletmesi ITHR'nin önemli avantajlarıdır.

Anahtar Kelimeler: Tek aşamalı cerrahi; hipospadias; proksimal; ada tüpü; iki aşamalı cerrahi
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