[Effect of surgical steps in primary hypospadias repair on penile length].

• DOI: 10.7507/1002-1892.202109038
• Publication Date: 2022-02-15
• Authors: Yunman Tang; Yu Liu; Xuejun Wang; Yu Mao; Daorui Qin; Bo Yang; Kangjie Peng; Chen Zhu; Jian Li; Shaoji Chen
• Keywords: Degloving; Penile curvature

To document the effect of surgical steps, including penile degloving, plate transection, dorsal plication, and fasciocutaneous coverage, in primary hypospadias repair on length.A consecutive series 209 prepubertal boys with was included age ranged from 10 to 97 months (mean, 31.7 months). Intraoperative stretched length (SPL) measured before operation ( n=209), after each step, namely degloving n=152), transection n=139), plication n=170), coverage n=209). SPLs steps or entire were analyzed. The SPL compared between group preservation group, non-plication without respectively. Differences analyzed factors neourethra length, rest ventral preoperative SPL, degree curvature multivariate linear regression analysis.All four resulted difference. increased P<0.05), decreased P<0.05). all completed In patients postoperative when that No significant difference noted P>0.05). And there a increase P<0.05) noted. no When excluded, cutanofascial not related However, influencing for P<0.05).The main can change SPL. lengthening would be counteracted by plication. Dorsal makes SPL.探讨尿道下裂初次矫治手术中阴茎脱套分离（脱套）、切断尿道板（断板）、阴茎海绵体背侧白膜折叠（背折）和筋膜皮肤覆盖操作对阴茎长度的影响。.以209例青春期前初次治疗的尿道下裂患儿作为研究对象，年龄10～97个月，平均31.7个月。于术前（ n=209）、脱套后（ n=152）、断板后（ n=139）、背折后（ n=170）、筋膜皮肤覆盖后（ n=209），测量阴茎牵拉长度并比较操作前后长度差异。根据术中处理，将患者分为断板组及保板组、背折组及未折组，同时将保板组进一步分为背折亚组及未折亚组；比较组间阴茎长度差异，分析上述处理对阴茎长度的影响。对脱套、断板、背折及筋膜皮肤覆盖处理前后阴茎长度差值与成形尿道长度、阴茎静息背侧长度、阴茎静息腹侧长度、术前阴茎长度及脱套后阴茎弯曲度进行多元线性回归分析，探讨阴茎长度的影响因素。.矫治术中脱套、断板后阴茎长度较前增加（ P<0.05），背折、筋膜皮肤覆盖后缩短（ P<0.05），所有操作完成后阴茎长度较术前增加（ P<0.05）。断板组术后阴茎长度较术前增加（ P<0.05），而保板组手术前后差异无统计学意义（ P>0.05）；断板组术后阴茎增加长度大于保板组（ P<0.05）。背折组术后阴茎长度较术前增加（ P<0.05），未折组手术前后阴茎长度差异无统计学意义（ P>0.05）；两组术后阴茎增加长度差异无统计学意义（ P>0.05）。保板组中，背折亚组与未折亚组组内手术前后阴茎长度比较，以及组间手术前后阴茎长度、术后阴茎增加长度比较，差异均无统计学意义（ P>0.05）。脱套、背折及筋膜皮肤覆盖后阴茎增加长度与成形尿道长度、阴茎静息背侧长度、阴茎静息腹侧长度、术前阴茎长度及脱套后阴茎弯曲度无相关（ P>0.05）；成形尿道长度及术前阴茎长度是断板后阴茎增加长度的影响因素（ P<0.05）。.尿道下裂初次矫治手术中各主要操作均会改变阴茎长度，断板增加的阴茎长度不会被背折导致的短缩完全抵消，单纯背折处理对术后阴茎长度无明显影响。.