The Effect Of Applying Recombinant Human Epidermal Growthfactor Hydrogel In Treatment Of Urethral Fistula After Hypospadias Repair

Hypospadias is a common congenital malformation in pediatricgenitourinary system,its etiology remains unclear,the incidence rate isrising in recent years.Abnormal foreskin, penile curvature and ectopicurethra are its main clinical manifestations.At present, surgical operationis the only effective way to treat hypospadias, So far various hypospadiasoperation methods haveemerged in an endless stream,Althoughthe operation methods continuous improvement,the success rate ofsurgery is also rising, but there are still many complications arise,Suchas urinary fistula, urethral stricture, chordee of penis correction failure orrecurrence, urethral diverticulum,and urinary fistula is the most common.So how to deal with urinary fistula after hypospadias become bothersomeproblem of pediatric urologists.Since recombinant human epidermalgrowth factor (rhEGF) could accelerate a variety of cell proliferation,differentiation and migration, such as epithelial cells, fibroblasts, newgranulation tissue formation and skin wounds re-epithelialization,whichhas promote healing,So for urinary fistula after hypospadias surgery inthe short term, on the basis of conventional treatment given rhEGFhydrogel treatment can promote urinary fistula healing and reduce painsecondary surgery to patients on physical and psychological, to reducethe economic burden, improve the success rate of surgery.Objective：To observe the application effect of recombinant humanepidermal growth factor (rhEGF) hydrogel in the early treatment ofurethral fistula after hypospadias repair,which could provide a method oftreatment in the early treatment of urinary fistula for clinicians.Methods:34patients with urethral fistula after hypospadias repair from2011October to2013December were divided into testgroup(17cases) and control group(17cases) at Random, All patients weretreated with indwelling catheter and wound dressing firstly, Then thetreatment group was treated with putting rhEGF hydrogel on the fistulasurface, while the fistula surface of control group with Physiologicalsaline, The two groups urinary fistula healing were observed.Results:10cases were healed in test group, the total healing rate is58.82%, There were6cases of large and multiple fistula, The remaining4cases were small fistula;While the control group were only4healingcases, the total healing rate is23.53%,The healed cases were1cases and3cases,respectively.The total healing rate and the healing rate of largeand multiple fistula in test group was significantly higher than that in thecontrol group, The difference was significant (P <0.05);The test group ofsmall fistula healing rate was slightly higher than that of the controlgroup,There was no significant difference (P>0.05).In patients withurinary fistula healing, the test group had2cases of urethral stenosis,thecontrol group had1case, but they had smooth urination after urethraldilation.The test group had1case of recurrent urinary fistula after the scaboff.Conclusion: With early and timely treatment on the urethral fistulaafter hypospadias repair,Most small fistula could heal, And theapplication of rhEGF hydrogel can obviously promotethe healing of thefistula,rhEGF hydrogel have significant effect and high securityin clinicalapplication.