Operation Method Of Hypospadias And Aplication Of Microsurgical Technique

Objectives：To explore the application of hypospadias phase Ⅰclinical efficacy of different surgical methods and microscopic surgicaltechniques, to sum up the experience in the treatment of the differentsurgical procedures, to improve the success rate of surgery, and to reducesurgical complications.Method：148cases of hypospadias were collected from March2006to March2012in Department of Urology, the Second Hospital ofJilin University. Preoperative assessment,148patients were male,surgical age from8months to17years old, with an average of4.5yearsold.108cases were diagnosed for the first time and40cases of referral:the first diagnosed cases were divided into two groups according towhether the merger penis curvature. The urethra forward the penis headangioplasty (MAGPI surgical) was selected in four cases; Tipping urethrabasal vascular flap urethroplasty (Mathieu procedure) of10cases；Stamped island flap urethroplasty (Onlay technique)21cases; sutureurethral plate urethroplasty (King surgical) two cases；The base of theurethra the the vascular skin tube urethroplasty the (Mustarde surgical)7;slitting roll tube urethral plate urethroplasty (Snodgrass procedure) formore than nine cases of hypospadias merge penile bending. Bend underthe merger penis using cross cut pedicled island package flapurethroplasty (Duckett technique)42cases; Duckett+Duplay13cases.Referral cases with no cut foreskin divided into two groups, croppedforeskin choice for those who Duckett technique18cases; the foreskin ofno cut choice for those who scrotal septal flap urethroplasty10cases;improved penile skin tube urethroplasty12cases of surgery (Thierschprocedure). Analysis of hypospadias in different parts of selected clinical efficacy of different surgical statistical incidence of urethral fistula andurethral stricture.Result：Postoperative complications were urinary fistula(23cases)and urethral stricture(3cases),no other complications.The averageoperation time was105.6±25.8minutes, the average length of hospitalstay of11.0±3.0days. There was no difference in groups withoutchordee of penis (P>0.05).The difference was significant in groups withchordee of penis(P<0.05).The difference was not significant in groups ofreturn visit(P>0.05).Conclusions： Using microsurgical techniques, choosing theappropriate surgical approach to the treatment of hypospadias,satisfactory results can be obtained. The appropriate surgical approachwas key to success. In this study, the surgical approach taken in theabsence of penile curvature is generally easier to grasp, Duckett+theDuplay surgical operation is difficult, requiring high skills, not easy tograsp.