Application Of Children Stomach Vessel For Orthotopic Urinary Drainage In Hypospadias Repair

OBJECTIVE:We improved the hypospadias postoperative urine drainage way, adopted three new urine drainage way, To investgate the advantages and shortcomings of four methods of bladder drainage in hypospadias repair,which contains children stomach vessel for urinary drainage, two-channel side holes children stomach vessel for urinary drainage and improved two-channel side holes children stomach vessel for urinary drainage and The pubis colostomy drainage in bladder,by comparing their valid urinary drainage and influnence to postoperative complications such as urethral fistula, stenosis and bladder spasm; to investgate the features of the four methods,sum up clinical experience and widely available。METHODS:A total of 306 patients were included in this retrospective study from January 2006 to April 2011 in the department of pediatric urology of Xiangya Hospital and Hunan Chridren's Hospital.All of these patients had undergone urethroplasty by one-stage repair or two-stage repair. All Cases are managed by the urethral drainage. All cases were divided into four groups by the method of bladder drainage.A group is children stomach vessel for urinary drainage,B group is two-channel side holes children stomach vessel for urinary drainage,C group is improved two-channel side holes children stomach vessel for urinary drainage. D group is the pubis colostomy drainage in bladder.Patients'age from 1 year 2 months to 14 years old.The average operation age is 4.78 years old.By the classification according to meatal location after chordee has been released,306 cases contain 5 glanular hypospadias,24 coronal hypospadias,168 penile shaft hypospadias,61 penoscrotal hypospadias,28 scrotal hypospadias and 20 perineal hypospadias. The time of follow up is 1 month to three years.To add up the rate of valid drainage of three methods,the postoperative complications, retention of drainage tube and length of stay in each group. All of the data were obtained from the clinical records and performed statistical analysis.RESULTS:A group had 83 cases,the rate of valid drainage was 98.8%,8 cases had fistula,7 cases had stenosis,3 cases had bladder spasm.B group had 68 cases,the rate of valid drainage was 97.1%,4 cases had fistula,3 cases had stenosis,7 cases had bladder spasm.C group had 71 cases,the rate of valid drainage was 98.6%,3 cases had fistula,2 cases had stenosis,4 cases had bladder spasm. D group had 84 cases,the rate of valid drainage was 96.4 %,24 cases had fistula,27 cases had stenosis,28 cases had bladder spasm.The retention of drainage tube and length of stay in A group were 14.38 and 20.46 days;in second group were 13.99 and 19.36 days;in C group were 13.24 and 19.11 days, in last group were 16.38 and 22.74 days.There was no remarkably statistical difference between A,B and C groups with bladder spasm, retention of drainage tube and length of stay.There was remarkably statistical difference between the last group and with valid drainage, bladder spasm, retention of drainage tube and length of stay.Also has remarkably statistical difference between the first three groups with fistula and stenosis.CONCLUSIONS:1. The three methods of children stomach vessel for urinary drainage which this issue involved can replace suprapubic cystotomy.They drainage fully and reduce complications,Also have various advantages. 2. In all the methods of children stomach vessel for urinary drainage, improved two-channel side holes children stomach vessel for urinary drainage is the best valid drainage, has obvious advantage.Strongly recommended.3. Pursue the details has important value to improve success rate of urethroplasty.