Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Tek Çocuk Ürolojisi Uzmanı Tarafından Yapılan Hipospadias Cerrahisi Sonuçları; 3 Yıllık Deneyim
Surgical Results of Hypospadias Surgery by Single Pediatric Urology Specialist; 3 Year Experience
Yaşar ISSIa
aGaziantep Cengiz Gökçek Kadın Doğum ve Çocuk Hastalıkları Hastanesi, Çocuk Ürolojisi Kliniği, Gaziantep, TÜRKİYE
Turkiye Klinikleri J Pediatr. 2020;29(1):1-7
doi: 10.5336/pediatr.2019-70704
Article Language: TR
Full Text
ÖZET
 Amaç: Hipospadias; sık rastlanan, seviyesine bağlı olarak cerrahi sonrası komplikasyon riski olan ve bu yüzden tedavisi tecrübe gerektiren bir konjenital anomalidir. Bu çalışmada, bir çocuk ürolojisi uzmanınca yapılan hipospadias onarımı cerrahi sonuçları değerlendirildi. Gereç ve Yöntemler: Ekim 2016-Mayıs 2019 tarihleri arasında, hipospadias nedeni ile ameliyat edilen ve en az 3 aylık takibi yapılan hastalar çalışmaya dâhil edildi. Toplam 246 hastaya bu süre içerisinde hipospadias onarımı yapılmış olup, takip dışı kalanlar ve takip süresi 3 aydan az olanlar çalışma dışı bırakılmıştır. Hastalar, 1, 3, 6. ay ve 1. yılda kontrole çağırıldılar. Kontroller sırasında hastalarda, üretrokutanöz fistül (UKF), meatal darlık veya üretral divertikül oluşup oluşmadığı araştırıldı. Bulgular: Toplamda 246 hasta opere edildi. Çalışmaya, takipleri yapılabilen 228 hasta dâhil edildi. Mediyan yaş 3,00 (1-16) yıl idi. Yüz otuz dokuz hasta distal, 69 hasta ise proksimal hipospadias nedeni ile opere edildi. Ayrıca 11 hasta, başka merkezde geçirilmiş operasyona sekonder UKF ve 9 hasta da kompleks (Cripple) hipospadias nedeni ile polikliniğimize başvurdu. Tüm bu hastalar kliniğimizde opere edildiler. Tüm hastaların %7'sinde meatal darlık, %7,8'inde ise UKF görüldü. Divertikül, meatal geri çekilme ve flep veya greft nekrozu hiçbir hastada gözlenmedi. Sonuç: Hipospadias, sık gözlenen ve onarımında çok sayıda tanımlanan ameliyatı olan bir hastalıktır. Komplikasyon riskinin düşük olmaması ve ek operasyon gerekebilmesi, bu hastalığın ameliyatının tecrübe sahibi kliniklerde yapılmasını zorunlu kılmaktadır.

Anahtar Kelimeler: Hipospadias; cerrahi sonuçlar; üretrokutanöz fistül; meatal darlık
ABSTRACT
 Objective: Hypospadias is a common congenital abnormality with a high rate of complications after surgery. Therefore, surgical expertise is required. In this study, the outcome of surgery performed by a pediatric urologist is investigated. Material and Methods: The patients who underwent surgery for hypospadias between October 2016-May 2019 in our hospital were included. Those with a follow-up of less than three months and patients out of followup were excluded from the study. Follow-up included visits at the 1st, 3rd, 6th months, and the 1st year and evaluation for complications including urethrocutaneous fistula (UCF), meatal stenosis and urethral diverticulum. Results: In total 246 patients were operated for hypospadias. The study included 228 patients who were followed-up properly. The median age was 3.00 (1-16) years. One hundred thirtynine patients with distal and 69 patients for proximal hypospadias were operated. In addition, 11 patients with UCF and 9 patients with cripple hypospadias applied to our hospital after being operated in another center. 7% of all patients had meatal stenosis and 7.8% had UCF. Urethral diverticulum, meatal retraction and flap or graft necrosis were not observed in any patient. Conclusion: Hypospadias is a frequently observed disease with many defined surgeries in its repair. Since the risk of complication is not low and additional surgery may be required, its surgery shall be performed in centers with expertise.

Keywords: Hypospadias; patient reported outcome measures; urethrocutaneous fistula; meatal stenosis
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