Analysis Of Clinical Effects Of Retaining Urethral Plate For Treatment Of Hypospadias

Research purpose: Through the comparison of the cure rate and complication rate between the two methods of retaining the urethral plate and transversing the urethral plate during the repair of hypospadias,To explore the clinical effects of urethral plate preservation in hypospadias repair.Methods: A retrospective analysis was conducted on the primary tr-eatment of hypospadias patients admitted to the Department of Urology,The Second Hospital of Jilin University from January 2011 to January 2017,and the patients which Include cryptorchidism,inguinal hernia and other urinary malformations were not treatmented at the same time as hypospadias repair in the study.A total of 92 patient-s met the criteria.The minimum age was no less than 12 months and the maximum was no more than 15 years,and Statistical analysis showed that the average age was 4.6 years.According to whether the urethral plate was preserved during surgery,92 subjects were divided into two groups.Among them,54 patients underwent hypospadias repair with preserved urethral plate,an-d were set as experimental group A group.According to the condition of the patients,38 cases need to transverse the urethral plate during the ope-ration,and be set as the control group B group.In group A,17 patients w-ere treated with Mathieu,22 cases were treated with Onlay and 15 cases were treated with Snodgrass.In group B,Duckett was used in 21 cases an-d Duckett+Duplay was used in 17 cases.In this study,the differences in preoperative age,weight,and serum testosterone values were statistically analyzed between the two groups,to maintain the univariate variables for comparing the two groups of surgery.The operative complications such as urinary fistula,urethral stricture,urethral diverticulum dilatation,skin nec-rosis,urethral collapse and other complications of the two surgical proce-dures were statistically calculated,at the same time,statistical analysis w-as performed on the time of operation and the time of removing the ureth-ral stent after surgery.Result: 1.By statistical analysis of the age,weight,and preoperative serum testosterone levels in the two groups,the age comparison between the two groups was P=1.00(>0.05),and there was no statistically significant difference in age.There was no significant difference in weight between the two groups P=0.993(>0.05).Preoperative serum testosterone levels were compared with P = 0.99(>0.05).There was no significant difference in preoperative serum testosterone levels.2.There was no statistically significant difference between the two groups in the operation time P=0.853(>0.05).3.There was a statistically significant difference between the two groups in the time to remove the urethral stent P=0.009(<0.05).4.According to the criteria for the treatment of hypospadias surgery,49 cases were cured of the 54 cases in the experimental group,the cure rate was 90.7%.24 of the 38 cases in the control group were cured after operation,the cure rate was 63.2%.The cure rate of the two groups was P=0.003(<0.05),and the difference was statistically significant.5.In the experimental group,there were 2 cases of urinary fistula after operation and 8 cases of urinary fistula occurred in the control group.The comparison between the two groups was P=0.014<P<0.05,and thedifference was statistically significant.In the experimental group,there was 1 case of urethral stricture after surgery,and 6 cases of urethral stricture occurred in the control group.The urethral stricture was P=0.018(<0.05),and the difference was statistically significant.Conclusion: In hypospadias repair,whether the use of urethral plates or transverse urethral plates,the average operative time is comparable.However,under the same conditions that can correct the urethral floor curvature,the time for retaining the urethral stent after the retention of the urethral plate is short,the cure rate of the hypospadias is high,and the postoperative complication rate is low.Therefore,clinicians are advised to consider the use of retention urethral plates in the repair of hypospadias.