Chinese Journal of Reparative and Reconstructive Surgery
Supervisor： National Health Commission of the People's Republic of ChinaSponsor： Chinese Association of Rehabilitation Medicine , Sichuan University Editor-in-chief：Bin Shen Publishing period：
Monthly
ISSN：1002-1892CN：51-1372/R
Department of Pediatric Surgery in Children’s Medical Center, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu Sichuan, 610072, P.R.China;
Objective To discuss the reoperation methods of urethral stricture after urethroplasty of hypospadias and their effectiveness.Methods Between September 2010 and April 2018, 169 patients with urethral stricture after urethroplasty of hypospadias, who underwent ineffective conservative treatments first, were accepted. The age ranged from 1 year and 7 months to 41years with a median age of 5 years and 8 months. The stricture located at the external urethral orifice in 80 cases, internal anastomosis connection in 87 cases, and constructed urethra in 2 cases. The symptoms of urethral stricture occurred at 2 weeks to 52 months after urethroplasty, with a median time of 4.5 months. The patients with external urethral orifice stenosis were treated with urethral meatus augmentation (74 cases) and urethral advancement (6 cases). The patients with internal anastomosis connection stenosis were treated with internal urethrotomy with urethroscopy (10 cases), urethrotomy and one-stage urethroplasty (26 cases), and urethrostomy (51 cases) including 43 cases of two-stage urethroplasty. The patients with constructed urethral stricture were treated with urethrolysis.Results One hundred and fifty-four patients were followed up 6–86 months with an average of 47 months. The stenosis was relieved in 137 cases, and re-stenosis in 12 cases, urethral fistula in 4 cases, all of which were treated successfully. In addition, 1 case with mild urethral diverticulum did not need to be treated.Conclusion If it is ineffective for the conservative treatment of urethral stricture after urethroplasty of hypospadias, appropriate surgical treatments could be selected according to the location and length of the stricture, local tissue conditions, complications, and so on.
Citation：WANG Xuejun, TANG Yunman, MAO Yu, QIN Daorui, CHEN Shaoji. Reoperation methods and effectiveness of urethral stricture after urethroplasty of hypospadias. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(2): 223-226. doi: 10.7507/1002-1892.201810057Copy
Copyright ? the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
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Blaschko SD, McAninch JW, Myers JB, et al. Repeat urethroplasty after failed urethral reconstruction: outcome analysis of 130 patients. J Urol, 2012, 188(6): 2260-2264.
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Andersson M, Doroszkiewicz M, Arfwidsson C, et al. Normalized urinary flow at puberty after tubularized incised plate urethroplasty for hypospadias in childhood. J Urol, 2015, 194(5): 1407-1413.
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1. Macedo A Jr, Rondon A, Ortiz V. Hypospadias. Curr Opin Urol, 2012, 22(6): 447-452.
2. Myers JB, McAninch JW, Erickson BA, et al. Treatment of adults with complications from previous hypospadias surgery. J Urol, 2012, 188(2): 459-463.
3. Blaschko SD, McAninch JW, Myers JB, et al. Repeat urethroplasty after failed urethral reconstruction: outcome analysis of 130 patients. J Urol, 2012, 188(6): 2260-2264.
5. Radojicic ZI, Perovic SV, Stojanoski KD. Calibration and dilatation with topical corticosteroid in the treatment of stenosis of neourethral meatus after hypospadias repair. BJU Int, 2006, 97(1): 166-168.
8. Gargollo PC, Cai AW, Borer JG, et al. Management of recurrent urethral strictures after hypospadias repair: is there a role for repeat dilatation or endoscopic incision? J Pediatr Urol, 2011, 7(1): 34-38.
9. Andersson M, Doroszkiewicz M, Arfwidsson C, et al. Normalized urinary flow at puberty after tubularized incised plate urethroplasty for hypospadias in childhood. J Urol, 2015, 194(5): 1407-1413.
10. Osterberg EC, Gaither TW, Awad MA, et al. Current practice patterns among members of the American Urological Association for male genitourinary lichen sclerosus. Urology, 2016, 92(1): 127-131.
12. Huang Y, Xie H, Lv Y, et al. One-stage repair of proximal hypospadias with severe chordee by in situ tubularization of the transverse preputial island flap. J Pediatr Urol, 2017, 13(3): 296-299.
15. Keays MA, Starke N, Lee SC, et al. Patient reported outcomes in preoperative and postoperative patients with hypospadias. J Urol, 2016, 195(4 Pt 2): 1215-1220.
18. Ansari MS, Agarwal S, Sureka SK, et al. Impact of changing trends in technique and learning curve on outcome of hypospadias repair: An experience from tertiary care center. Indian J Urol, 2016, 32(3): 216-220.
21. Perera M, Jones B, O’Brien M, et al. Long-term urethral function measured by uroflowmetry after hypospadias surgery: comparison with an age matched control. J Urol, 2012, 188(4 Suppl): 1457-1462.
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Citation：WANG Xuejun, TANG Yunman, MAO Yu, QIN Daorui, CHEN Shaoji. Reoperation methods and effectiveness of urethral stricture after urethroplasty of hypospadias. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(2): 223-226. doi: 10.7507/1002-1892.201810057
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