Русский
Evaluation of the clinical efficacy of urethroplasty after failed hypospadias repair
DOI: https://dx.doi.org/10.18565/urology.2020.1.5-11
S.I. Gamidov, D.Yu. Pushkar, A.O. Vasiliev, A.V. Govorov, R.N. Dusmukhamedov, M.G. Shneiderman, T.V. Shatylko, N.G. Gasanov
1) Department of Andrology and Urology of National Medical Research Center of Obstetrics, Gynecology and Perinatology named after V.I. Kulakov of the Ministry of Health of Russia, Moscow, Russia; 2) Department of Obstetrics, Gynecology, Perinatology and Reproductology of I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University); 3) Department of Additional Technologies for treatment of infertility named after professor B.V. Leonov of National Medical Research Center of Obstetrics, Gynecology and Perinatology named after V.I. Kulakov of the Ministry of Health of Russia, Moscow, Russia; 4) Department of Urology of A.I. Evdokimov Moscow State University of Medicine and Dentistry of Ministry of Health of Russia, Moscow, Russia; 5) Department of Urology and Andrology in N.I. Pirogov RNRMU, Moscow, Russia
Background. Evaluation of surgical treatment of hypospadias is one of the most controversial problem in urology, considering a lack of continuity in the management of these patients between pediatric andrologists and general urologists. Patients who undergone to multiple hypospadias repairs remain one of the most difficult categories for reconstructive urethral surgery and urology in general.
Materials and methods. The treatment results of 112 adult patients who had complications of previously performed hypospadias repairs were evaluated. The results of repeated procedures were compared in patients, in whom modified balloon urethral catheter (group 1; n=50) or standard Foley catheter (group 2; n=62) was used, respectively.
Results. Most patients after surgery assessed the appearance of the penis as “good” (92% in group 1, 77.4% in group 2). In group 1, satisfactory results was seen in 8% of cases and there were no unsatisfactory results, while in group 2, where standard Foley catheter was used, these values were 19.4% and 3.2%, respectively. In group 1, complication rate was lower than in group 2 (10% versus 41.9%; p<0.05). In group 1, there was a significantly higher proportion of patients with a Qmax score of ≥ 18 ml/s (90% versus 74.2%; p<0.05).
Conclusions. Repeated procedures in adult men with late complications of surgical treatment of hypospadias are quite effective, although they are accompanied by a rather high complications rate. The use of a new model of the urethral catheter with dilating cuff and an irrigation canal allows to improve treatment results in this category of patients.
Materials and methods. The treatment results of 112 adult patients who had complications of previously performed hypospadias repairs were evaluated. The results of repeated procedures were compared in patients, in whom modified balloon urethral catheter (group 1; n=50) or standard Foley catheter (group 2; n=62) was used, respectively.
Results. Most patients after surgery assessed the appearance of the penis as “good” (92% in group 1, 77.4% in group 2). In group 1, satisfactory results was seen in 8% of cases and there were no unsatisfactory results, while in group 2, where standard Foley catheter was used, these values were 19.4% and 3.2%, respectively. In group 1, complication rate was lower than in group 2 (10% versus 41.9%; p<0.05). In group 1, there was a significantly higher proportion of patients with a Qmax score of ≥ 18 ml/s (90% versus 74.2%; p<0.05).
Conclusions. Repeated procedures in adult men with late complications of surgical treatment of hypospadias are quite effective, although they are accompanied by a rather high complications rate. The use of a new model of the urethral catheter with dilating cuff and an irrigation canal allows to improve treatment results in this category of patients.
About the Autors
Corresponding author: R.N. Dusmukhamedov – Ph.D. student at the Department of Urology and Andrology in N.I. Pirogov RNRMU; e-mail: runisdusmuhamedov@mail.ru
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