ONE-STAGE NONSTENTED TUBULARIZED INCISED PLATE URETHROPLASTY FOR PAIN AND COMPLICATION AFTER HYPOSPADIAS REPAIR_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIXiaodong ,  XUNing , XUEXueyi , WEIYong , ZHENGQingshui , SUNXionglin , CAIHai , JIANGTao

Department of Urology, the First Affiliated Hospital of Fujian Medical University, Fuzhou Fujian, 350005, P. R. China;

Corresponding?author：

XUNing, Email: drxun@163.com

Keywords：

Tubularized incised plate urethroplasty; Hypospadias; Drainage way; Postoperative complication

DOI：

10.7507/1002-1892.20140326

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Objective To comparatively analyze the effect of one-stage nonstented tubularized incised plate urethroplasty (TIP) on operative pain and compl ication by comparing with urethral catheter and urethral stent drainages. Methods Between March 2010 and June 2013, 214 cases of distal and mid-shaft hypospadias underwent TIP, and the cl inical data were analyzed retrospectively. The patients were divided into 3 groups based on different urinary drainage techniques: indwell ing urethral catheter was used in 68 cases (group A), indwell ing urethral stent in 70 cases (group B), and nonstented drainage in 76 cases (group C). There was no significant difference in age, hypospadias type, and accompany malformation among 3 groups (P>0.05). At 2 days after operation, Wong-Banker facial scale (WBS) and Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) were used for pain and praxiology assessment. The complications after operation also were observed and compared among 3 groups. Results All patients were followed up 6-25 months (median, 11.8 months). At 2 days after operation, the median WBS scores were 4.0 (0-10), 3.5 (0-10), and 3.0 (0-10) in groups A, B, and C, respectively; median CHEOPS pain scores were 6.0 (1-13), 6.0 (1-13), and 4.0 (1-11), respectively. The WBS pain score and CHEOPS pain score in group C were significantly lower than those in groups A and B (P<0.05), but there was no significant difference between group A and group B (P>0.05). The postoperative complication occurred in 27 cases (39.7%) of group A, 29 cases (41.4%) of group B, and 13 cases (17.1%) of group C; two or more than two complications occurred in 14, 15, and 9 cases, respectively. There was significant difference in total incidence of postoperative complication among 3 groups (P<0.05). The incidences of postoperative overactive bladder, bladder spasms, urinary tract infection, and fistula in group C were significantly lower than those in groups A and B (P<0.05). There was no significant difference in incision infection, acute urinary retention, urinary extravasation, meatal stenosis, and urethral stricture among 3 groups (P>0.05). Conclusion One-stage nonstented TIP is suitable for distal and mid-shaft hypospadias and could reduce postoperative pain and complications compared with the traditional postoperative indwell ing urethral catheter and indwell ing urethral stent.

Citation： LIXiaodong, XUNing, XUEXueyi, WEIYong, ZHENGQingshui, SUNXionglin, CAIHai, JIANGTao. ONE-STAGE NONSTENTED TUBULARIZED INCISED PLATE URETHROPLASTY FOR PAIN AND COMPLICATION AFTER HYPOSPADIAS REPAIR. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(12): 1505-1508. doi: 10.7507/1002-1892.20140326 Copy

1.	?魏勇, 李曉東, 許寧, 等. 尿道下裂術后患者陰莖外觀、性功能和性滿意度遠期隨訪研究. 中華男科學雜志, 2014, 20(1):48-53.
2.	Rompré MP, Nadeau G, Moore K, et al. Learning curve for TIP urethroplasty: A single-surgeon experience. Can Urol Assoc J, 2013, 7(11-12):E789-E794.
3.	Chin KY, Burchette D, Uppal R. Urethral stent in hypospadias repair. J Plast Reconstr Aesthet Surg, 2013, 66(8):1158-1160.
4.	Arda IS, Mahmuto?lu M. Urethral catheterization in hypospadias surgery: Should the device enter the bladder or be made a urethral stent? J Pediatr Surg, 2001, 36(12):1829-1831.
5.	Hosseinpour M, Noori S, Amir-Beigi M, et al. Safety of latex urinary catheters for the short time drainage. Urol Ann, 2014, 6(3):198-201.
6.	Chin KY, Burchette D, Uppal R. Urethral stent in hypospadias repair. J Plast Reconstr Aesthet Surg, 2013, 66(8):1158-1160.
7.	Hardwicke J, Jones E, Wilson-Jones N. Optimization of silicone urinary catheters for hypospadias repair. J Pediatr Urol, 2010, 6(4):385-388.
8.	Xu N, Xue XY, Li XD, et al. Comparative outcomes of the tubularized incised plate and transverse island flap onlay techniques for the repair of proximal hypospadias. Int Urol Nephrol, 2014, 46(3):487-491.
9.	Turial S, Enders J, Engel V, et al. Stent-free tubularized incised plate (TIP) repair of distal and mid-shaft hypospadias irrespective of age. Eur J Pediatr Surg, 2011, 21(3):168-170.
10.	Miró J, Castarlenas E, Huguet A. Evidence for the use of a numerical rating scale to assess the intensity of pediatric pain. Eur J Pain, 2009, 13(10):1089-1095.
11.	Yu H, Liu Y, Li S, et al. Effects of music on anxiety and pain in children with cerebral palsy receiving acupuncture:a randomized controlled trial. Int J Nurs Stud, 2009, 46(11):1423-1430.
12.	Castagnetti M, El-Ghoneimi A. The influence of perioperative factors on primary severe hypospadias repair. Nat Rev Urol, 2011, 8(4):198-206.
13.	許寧, 薛學義, 魏勇, 等. 尿道下裂術后通過尿道支架早期排尿減少尿瘺發生:一項單中心回顧性研究. 中國男科學雜志, 2012, 26(6): 25-27.
14.	Hafez AT, Herz D, B?gliD, et al. Healing of unstented tubularized incised plate urethroplasty:an experimental study in a rabbit model. BJU Int, 2003, 91(1):84-88.
15.	Xu N, Xue XY, Wei Y, et al. Outcome analysis of tubularized incised plate repair in hypospadias:is a catheter necessary? Urol Int, 2013, 90(3):354-357.
16.	Wilkinson DJ, Farrelly P, Kenny SE. Outcomes in distal hypospadias:a systematic review of the Mathieu and tubularized incised plate repairs. J Pediatr Urol, 2012, 8(3):307-312.
17.	Almodhen F, Alzahrani A, Jednak R, et al. Nonstented tubularized incised plate urethroplasty with Y-to-I spongioplasty in non-toilet trained children. Can Urol Assoc J, 2008, 2(2):110-114.
18.	Kazemi Rashed F, Gholizade R. Comparison of distal hypospadias repair in circumcised patients and uncircumcised patients. ISRN Urol, 2013, 2013:957581.

1. ?魏勇, 李曉東, 許寧, 等. 尿道下裂術后患者陰莖外觀、性功能和性滿意度遠期隨訪研究. 中華男科學雜志, 2014, 20(1):48-53.
2. Rompré MP, Nadeau G, Moore K, et al. Learning curve for TIP urethroplasty: A single-surgeon experience. Can Urol Assoc J, 2013, 7(11-12):E789-E794.
3. Chin KY, Burchette D, Uppal R. Urethral stent in hypospadias repair. J Plast Reconstr Aesthet Surg, 2013, 66(8):1158-1160.
4. Arda IS, Mahmuto?lu M. Urethral catheterization in hypospadias surgery: Should the device enter the bladder or be made a urethral stent? J Pediatr Surg, 2001, 36(12):1829-1831.
5. Hosseinpour M, Noori S, Amir-Beigi M, et al. Safety of latex urinary catheters for the short time drainage. Urol Ann, 2014, 6(3):198-201.
6. Chin KY, Burchette D, Uppal R. Urethral stent in hypospadias repair. J Plast Reconstr Aesthet Surg, 2013, 66(8):1158-1160.
7. Hardwicke J, Jones E, Wilson-Jones N. Optimization of silicone urinary catheters for hypospadias repair. J Pediatr Urol, 2010, 6(4):385-388.
8. Xu N, Xue XY, Li XD, et al. Comparative outcomes of the tubularized incised plate and transverse island flap onlay techniques for the repair of proximal hypospadias. Int Urol Nephrol, 2014, 46(3):487-491.
9. Turial S, Enders J, Engel V, et al. Stent-free tubularized incised plate (TIP) repair of distal and mid-shaft hypospadias irrespective of age. Eur J Pediatr Surg, 2011, 21(3):168-170.
10. Miró J, Castarlenas E, Huguet A. Evidence for the use of a numerical rating scale to assess the intensity of pediatric pain. Eur J Pain, 2009, 13(10):1089-1095.
11. Yu H, Liu Y, Li S, et al. Effects of music on anxiety and pain in children with cerebral palsy receiving acupuncture:a randomized controlled trial. Int J Nurs Stud, 2009, 46(11):1423-1430.
12. Castagnetti M, El-Ghoneimi A. The influence of perioperative factors on primary severe hypospadias repair. Nat Rev Urol, 2011, 8(4):198-206.
13. 許寧, 薛學義, 魏勇, 等. 尿道下裂術后通過尿道支架早期排尿減少尿瘺發生:一項單中心回顧性研究. 中國男科學雜志, 2012, 26(6): 25-27.
14. Hafez AT, Herz D, B?gliD, et al. Healing of unstented tubularized incised plate urethroplasty:an experimental study in a rabbit model. BJU Int, 2003, 91(1):84-88.
15. Xu N, Xue XY, Wei Y, et al. Outcome analysis of tubularized incised plate repair in hypospadias:is a catheter necessary? Urol Int, 2013, 90(3):354-357.
16. Wilkinson DJ, Farrelly P, Kenny SE. Outcomes in distal hypospadias:a systematic review of the Mathieu and tubularized incised plate repairs. J Pediatr Urol, 2012, 8(3):307-312.
17. Almodhen F, Alzahrani A, Jednak R, et al. Nonstented tubularized incised plate urethroplasty with Y-to-I spongioplasty in non-toilet trained children. Can Urol Assoc J, 2008, 2(2):110-114.
18. Kazemi Rashed F, Gholizade R. Comparison of distal hypospadias repair in circumcised patients and uncircumcised patients. ISRN Urol, 2013, 2013:957581.

Chinese Journal of Reparative and Reconstructive Surgery

ONE-STAGE NONSTENTED TUBULARIZED INCISED PLATE URETHROPLASTY FOR PAIN AND COMPLICATION AFTER HYPOSPADIAS REPAIR

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