Impacts Of Penile Degloving On Curvature Correction In Children With Hypospadias

Objectives To investigate the therapeutic effects of penile gloving on penile ventral curvature(VC)in children with hypospadias and analyze the related factors.Materials and Methods The patients were retrospectively analyzed who underwent the first urethroplasty in our hospital from October 2014 to December 2017.The children were classified into proximal,middle and distal hypospadias according to the position of urethral meatus after straightening.According to preoperative VC,patients were divided into mild group(< 30 °),moderate group(30 °,45 °)and severe group(> 45 °);Then the effects of penile degloving were evaluated by the percentage of NO VC and improvement VC.In addition,according to the effects of penile degloving,the related factors of NO VC group and residual VC group were analyzed.SPSS statistical analysis software was used to address all these data.Results This study included 400 patients in which the numbers of distal,middle,and proximal hypospadias were 72(17.7%),158(38.9%)and 176(43.4%)respectively,and the average age was 28.10 months(6 ~ 140 month).There were statistically significant differences in the percentage of NO VC and the percentage of improvement VC among the different three types of hypospadias(P <0.05).And in different VC Severity,the percentages of NO VC and improvement VC in mild-moderate VC were greater than severe VC,and there were statistically differences among the three group(P<0.05).In addition,the ROC curve also showed that the degree of preoperative penile curvature was 32.5°,the best cutoff value to predict the resist VC after penile degloving,and the sensitivity was 0.8272 and the specificity was 0.7301,which was statistically significant(P<0.05).Compared with the NO VC group after penile degloving,penile development of residual VC group was poor,such as the preoperative penis length,the diameter of coronary ditch and the percentage of penoscrotal transposition were significantly higher,and there were statistically differences(P<0.05);In addition,the urethral development was also poorer,such as the length of urethral plate(UP),the level of division of the corpus spongiosum(CS)and the proportion of poor CS were significantly higher than NO VC group(P < 0.05).Conclusions When dealing with VC deformity in children with hypospadias,penile degloving alone can correct VC,especially in distalmiddle hypospadias or mild-moderate VC deformity,and the preoperative degree of curvature can predict the effects of penile degloving.In addition,the residual VC deformities after penile degloving maybe caused by dysplastic ventral tissues.