Research Article
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Erişkin yaş hipospadias onarımında tubularized-incised plate urethroplasty yönteminin etkinliği.

Year 2018, , 95 - 99, 14.05.2018
https://doi.org/10.5505/ptd.2017.15986

Abstract

GİRİŞ ve AMAÇ: Biz bu çalışmada hipospadiası olan erişkin hastalarda
Tubularized-incised plate urethroplasty onarımının etkinliğini ve
yapılabilirliğini değerlendirmeyi amaçladık.

YÖNTEM ve GEREÇLER: Mart 2013 ve Şubat 2016 tarihleri arasında primer
hipospadias tanısı ile tubularized-incised plate urethroplasty onarımı yapılan
12 erişkin hasta çalışmaya dâhil edildi. Ortalama hasta yaşı, eksternal mea
yerleşimi, penil eğrilik varlığı ile ortalama operasyon süresi, cerrahi
komplikasyonlar, üretral kateter çıkarılma zamanı ve hastanede kalış süreleri
geriye dönük olarak analiz edildi. Hastaların tamamına ameliyat sonrası 6. ayda
üroflowmetri yapıldı. Cerrahi başarı penis ucunda stenotik olmayan yeni
üretranın varlığı ve üroflowmetride azami idrar akışının >20 mL/sn olması
olarak belirlendi.

BULGULAR: Ortalama hasta yaşı 22.1 yıl idi. Ortalama operasyon süresi, hastanede
kalış süresi ve üretral katater çıkarılma zamanı sırasıyla 105 dakika, 3 ve
8,16 gün olarak belirlendi. 2 hastada hafif penis eğriliği izlendi. Erken
dönemde her hangi bir komplikasyon izlenmedi. Ortalama 19 aylık takip döneminde
bir hastada üretrokutanöz fistül gelişti. Cerrahi başarı %91,6 olarak
belirlendi. Ameliyat sonrası yapılan üroflowmetride fistül gelişen hasta
dışındaki bütün hastalarda azami idrar akış hızı >20 mL/sn idi.

TARTIŞMA ve SONUÇ: Hipospadiası olan erişkin hastalarda tubularized-incised
plate urethroplasty onarımı, kabul edilebilir kozmetik ve fonksiyonel sonuçlar
ile etkin ve uygulanabilir bir yöntemdir.

Türkçe Kısa Başlık: Erişkin hipospadiasta TIPU onarımı.


References

  • 1. Duckett JW. Hypospadias. In Walsh PC, Retik AB, Vaughan ED Jr, Wein AJ. Campbell’s Urology, 7th ed, Philadelphia: WB Saunders, 1998;2093-2119.
  • 2. Snodgrass W. Tubularized, incised plate urethroplasty for distal hypospadias. J Urol 1994;151:464-465.
  • 3. Snodgrass W, Koyle M, Manzoni G, Horowitz R, Caldamone A, Ehrlich R. Tubularized incised plate hypospadias repair, results of a multicenter experience. J Urol 1996;156:839-841.
  • 4. Snodgrass W, Koyle M, Manzoni G, Horowitz R, Caldamone A, Ehrlich R. Tubularized incised plate hypospadias repair for proximal hypospadias. J Urol 1998;159:2129-2131.
  • 5. Senkul T, Karademir K, Işeri C, Erden D, Baykal K, Adayener C. Hypospadias in adults. Urology 2002;60:1059-1062.
  • 6. Myers JB, McAninch JW, Erickson BA, Breyer BN. Treatment of Adults with Complications from Previous Hypospadias Surgery. J Urol 2012;188:459-463.
  • 7. Adayener C, Akyol I. Distal hypospadias repair in adults: the results of 97 cases. Urol Int 2006;76:247-251.
  • 8. Snodgrass W, Villanueva C, Bush N. Primary and reoperative hypospadias repair in adults--are results different than in children? J Urol 2014;192:1730-1733.
  • 9. Polat H, Gulacti U, Gok A, et al. The success of tubularized-incised plate urethroplasty in adults and children. Springerplus 2016;5:689-692.
  • 10. Sharma G. Tubularized-incised plate urethroplasty in adults. BJU Int 2005;95:374-376.
  • 11. Khandelwal SK. Complete loss of libido with short-term use of lorazepam. Am J Psychiatry. 1988;145:1313-1314.
  • 12. Orri M, Lipset CH, Jacobs BP, Costello AJ, Cummings SR. Web-based trial to evaluate the efficacy and safety of tolterodine ER 4 mg in participants with overactive bladder: REMOTE trial. Contemp Clin Trials. 2014;38:190-197.

Efficacy of tubularized-incised plate urethroplasty in the management of adult hypospadias..

Year 2018, , 95 - 99, 14.05.2018
https://doi.org/10.5505/ptd.2017.15986

Abstract

INTRODUCTION: We aim to evaluate efficacy and feasibility of tubularized-incised plate urethroplasty repair in adult patients with hypospadias
METHODS: Between March 2013 and February 2016, 12 adult patients with primary hypospadias who underwent tubularized-incised plate urethroplasty repair were included in this study. The mean age of patients, location of urethra, existence of penile chordee, and the mean operation time, operative complications, urethral catheter removal time and length of hospital stay were analyzed retrospectively. All patients received uroflowmetry at postoperative 6th months. Surgical success was determined as a good cosmetic appearance with non-stenotic vertical meatus at tip of the penis and a uroflowmetry with a maximum urinary flow rate > 20 mL/sc.
RESULTS: The mean patient age was 22.1 years. The mean operation time, length of hospital stay and urethral catheter removal time were 105 minutes, 3 and 8,16 days, respectively. Two patients have mild penile chordee. No early post-operative complication has occurred. The urethocutaneous fistula was observed in one patient at the mean follow up of 19 months. Surgical success was determined as %91,6. Mean Q max on post-operative uroflowmetry was measured as >20 mL/sc in all patients except one who have urethrocutaneous fistula formation. 
DISCUSSION AND CONCLUSION: Tubularized-incised plate urethroplasty repair seems as an effective and feasible treatment in adult hypospadias patients with acceptable cosmetic and functional result.

İngilizce Kısa Başlık: TIPU repair in adult hypospadias.

 

References

  • 1. Duckett JW. Hypospadias. In Walsh PC, Retik AB, Vaughan ED Jr, Wein AJ. Campbell’s Urology, 7th ed, Philadelphia: WB Saunders, 1998;2093-2119.
  • 2. Snodgrass W. Tubularized, incised plate urethroplasty for distal hypospadias. J Urol 1994;151:464-465.
  • 3. Snodgrass W, Koyle M, Manzoni G, Horowitz R, Caldamone A, Ehrlich R. Tubularized incised plate hypospadias repair, results of a multicenter experience. J Urol 1996;156:839-841.
  • 4. Snodgrass W, Koyle M, Manzoni G, Horowitz R, Caldamone A, Ehrlich R. Tubularized incised plate hypospadias repair for proximal hypospadias. J Urol 1998;159:2129-2131.
  • 5. Senkul T, Karademir K, Işeri C, Erden D, Baykal K, Adayener C. Hypospadias in adults. Urology 2002;60:1059-1062.
  • 6. Myers JB, McAninch JW, Erickson BA, Breyer BN. Treatment of Adults with Complications from Previous Hypospadias Surgery. J Urol 2012;188:459-463.
  • 7. Adayener C, Akyol I. Distal hypospadias repair in adults: the results of 97 cases. Urol Int 2006;76:247-251.
  • 8. Snodgrass W, Villanueva C, Bush N. Primary and reoperative hypospadias repair in adults--are results different than in children? J Urol 2014;192:1730-1733.
  • 9. Polat H, Gulacti U, Gok A, et al. The success of tubularized-incised plate urethroplasty in adults and children. Springerplus 2016;5:689-692.
  • 10. Sharma G. Tubularized-incised plate urethroplasty in adults. BJU Int 2005;95:374-376.
  • 11. Khandelwal SK. Complete loss of libido with short-term use of lorazepam. Am J Psychiatry. 1988;145:1313-1314.
  • 12. Orri M, Lipset CH, Jacobs BP, Costello AJ, Cummings SR. Web-based trial to evaluate the efficacy and safety of tolterodine ER 4 mg in participants with overactive bladder: REMOTE trial. Contemp Clin Trials. 2014;38:190-197.
There are 12 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Cem Başataç

Publication Date May 14, 2018
Submission Date September 17, 2017
Acceptance Date October 27, 2017
Published in Issue Year 2018

Cite

AMA Başataç C. Erişkin yaş hipospadias onarımında tubularized-incised plate urethroplasty yönteminin etkinliği. Pam Tıp Derg. May 2018;11(2):95-99. doi:10.5505/ptd.2017.15986
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