Surgical efficacy of tubularized incised plate urethroplasty applying for Buck's fascia coverage in the treatment of hypospadias

Objective: The aim of this study was to compare the effectiveness of Buck's fascia and dartos fascia in covering the neourethra during tubularized incised plate urethroplasty (TIPU) for treating hypospadias in children. Methods: We conducted a retrospective analysis of 100 cases of hypospadias...

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Main Authors: Qian Zhou, Wei-ping Zhang, Xin Ni, Hong-cheng Song
Format: Article
Language:English
Published: Elsevier 2023-12-01
Series:Journal of Pediatric Surgery Open
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2949711623000886
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author Qian Zhou
Wei-ping Zhang
Xin Ni
Hong-cheng Song
author_facet Qian Zhou
Wei-ping Zhang
Xin Ni
Hong-cheng Song
author_sort Qian Zhou
collection DOAJ
description Objective: The aim of this study was to compare the effectiveness of Buck's fascia and dartos fascia in covering the neourethra during tubularized incised plate urethroplasty (TIPU) for treating hypospadias in children. Methods: We conducted a retrospective analysis of 100 cases of hypospadias treated with TIPU at the Department of Urology, Beijing Children's Hospital from January 2019 to September 2021. The cases were divided into two groups (A and B) based on the type of intraoperative neourethral covering used during surgery. Group A (n = 53) was covered with Buck's fascia, while group B (n = 47) was covered with dartos fascia. Two experienced surgeons performed the surgeries in their respective groups. We recorded general clinical data, intraoperative measurements, and postoperative follow-up data for both groups and analyzed the results statistically. Results: There were no significant differences in clinical data, such as mean age, urethral opening position, penile length, urethral plate width, urethral defect length, preoperative penile curvature and follow-up time (P > 0.05) between the two groups. However, group A had a wider glans and a lower proportion of dorsal tunica albuginea plication to correct penile curvature but a higher proportion of 6F catheters left in place (P < 0.05). c, group A reported 12 cases (22.6 %) of complications including eight cases (15.1 %) of urethral stricture and five cases (9.4 %) of urethral fistula; four cases were related to penile corporal fistula while one related to coronal fistula. On the other hand, group B reported 17 cases (36.2 %) of complications including three cases (6.4 %) of urethral stricture and fourteen cases (29.8 %) of urethral fistula; four cases were related to penile corporal fistula while one related to coronal fistula. A multifactorial analysis incorporating confounding factors revealed a lower incidence rate for urethral fistulas in group A compared to group B(P < 0 0.05). Conclusion: The application of Buck's fascia to cover the new urethra can effectively reduce the incidence of urethral fistula in TIPU, and the quality of Buck's fascia and suture tension should be taken into account to avoid the formation of urethral strictures.
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spelling doaj.art-020fc942bdbd42c5a140673f975ea1272023-12-10T06:19:57ZengElsevierJournal of Pediatric Surgery Open2949-71162023-12-014100091Surgical efficacy of tubularized incised plate urethroplasty applying for Buck's fascia coverage in the treatment of hypospadiasQian Zhou0Wei-ping Zhang1Xin Ni2Hong-cheng Song3Department of Urology, National Center for Children's Health, Beijing Children's Hospital Afliated to Capital Medical University, Beijing 100045, ChinaDepartment of Urology, National Center for Children's Health, Beijing Children's Hospital Afliated to Capital Medical University, Beijing 100045, ChinaDepartment of Otolaryngology, National Center for Children's Health, Beijing Children's Hospital Afliated to Capital Medical University, Beijing 100045, China; Corresponding author.Department of Urology, National Center for Children's Health, Beijing Children's Hospital Afliated to Capital Medical University, Beijing 100045, ChinaObjective: The aim of this study was to compare the effectiveness of Buck's fascia and dartos fascia in covering the neourethra during tubularized incised plate urethroplasty (TIPU) for treating hypospadias in children. Methods: We conducted a retrospective analysis of 100 cases of hypospadias treated with TIPU at the Department of Urology, Beijing Children's Hospital from January 2019 to September 2021. The cases were divided into two groups (A and B) based on the type of intraoperative neourethral covering used during surgery. Group A (n = 53) was covered with Buck's fascia, while group B (n = 47) was covered with dartos fascia. Two experienced surgeons performed the surgeries in their respective groups. We recorded general clinical data, intraoperative measurements, and postoperative follow-up data for both groups and analyzed the results statistically. Results: There were no significant differences in clinical data, such as mean age, urethral opening position, penile length, urethral plate width, urethral defect length, preoperative penile curvature and follow-up time (P > 0.05) between the two groups. However, group A had a wider glans and a lower proportion of dorsal tunica albuginea plication to correct penile curvature but a higher proportion of 6F catheters left in place (P < 0.05). c, group A reported 12 cases (22.6 %) of complications including eight cases (15.1 %) of urethral stricture and five cases (9.4 %) of urethral fistula; four cases were related to penile corporal fistula while one related to coronal fistula. On the other hand, group B reported 17 cases (36.2 %) of complications including three cases (6.4 %) of urethral stricture and fourteen cases (29.8 %) of urethral fistula; four cases were related to penile corporal fistula while one related to coronal fistula. A multifactorial analysis incorporating confounding factors revealed a lower incidence rate for urethral fistulas in group A compared to group B(P < 0 0.05). Conclusion: The application of Buck's fascia to cover the new urethra can effectively reduce the incidence of urethral fistula in TIPU, and the quality of Buck's fascia and suture tension should be taken into account to avoid the formation of urethral strictures.http://www.sciencedirect.com/science/article/pii/S2949711623000886ChildrenHypospadiasUrethroplastyCoverage
spellingShingle Qian Zhou
Wei-ping Zhang
Xin Ni
Hong-cheng Song
Surgical efficacy of tubularized incised plate urethroplasty applying for Buck's fascia coverage in the treatment of hypospadias
Journal of Pediatric Surgery Open
Children
Hypospadias
Urethroplasty
Coverage
title Surgical efficacy of tubularized incised plate urethroplasty applying for Buck's fascia coverage in the treatment of hypospadias
title_full Surgical efficacy of tubularized incised plate urethroplasty applying for Buck's fascia coverage in the treatment of hypospadias
title_fullStr Surgical efficacy of tubularized incised plate urethroplasty applying for Buck's fascia coverage in the treatment of hypospadias
title_full_unstemmed Surgical efficacy of tubularized incised plate urethroplasty applying for Buck's fascia coverage in the treatment of hypospadias
title_short Surgical efficacy of tubularized incised plate urethroplasty applying for Buck's fascia coverage in the treatment of hypospadias
title_sort surgical efficacy of tubularized incised plate urethroplasty applying for buck s fascia coverage in the treatment of hypospadias
topic Children
Hypospadias
Urethroplasty
Coverage
url http://www.sciencedirect.com/science/article/pii/S2949711623000886
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