Objective: To investigate the risk factors for the complications of urethroplasty in patients with primary hypospadias by postoperative follow-up observation.
Methods: We retrospectively analyzed 110 cases of primary hypospadias repair performed from November 2010 to October 2015, including 70 cases of tubularized incised plate (TIP) urethroplasty and 40 cases of inlay internal preputial graft (IIPG) urethroplasty, all with the urethral plate reserved. We followed up the patients for 15.6－36 months, (27.3 ± 0.52) mo for those with and (26.9 ± 0.22) mo for those without complications. The mean age of the two groups of patients was (7.5 ± 0.2) and (7.0 ± 0.5) yr, respectively.
Results: The follow-up data were collected from all the patients, 17 (15.5%) with and 93 (84.5%) without complications. The success rate of surgery was 84.5%. There were no statistically significant differences in the follow-up time and age between the two groups of patients (P >0.05). Single-factor analysis of variance showed significant differences between the complication and non-complication groups in the preoperative urethral opening (P <0.01), ventral penile curvature (P <0.01), and length of urethral defect (P = 0.04), while multiple linear regression analysis exhibited that only ventral curvature was associated with the postoperative complications of the patients (OR = 1.12, 95% CI: 1.06－1.19, P<0.01).
Conclusions: We chose single-stage urethroplasty with the urethral plate reserved for the treatment of primary hypospadias and achieved satisfactory outcomes. Ventral penile curvature is an independent risk factor for the complications of primary hypospadias, and a higher degree of curvature is associated with a higher incidnece of complications.
目的： 随访观察我院首次尿道下裂患者疗效及并发症，探究影响尿道下裂术后并发症的影响因素。方法： 收集从2010年11月至2015年10月接受手术的尿道下裂患者110例，均为初次接受手术治疗。其中接受TIP手术的患者70例，IIPG手术40例，均为一次尿道成形术。术后随访后分为两组：有并发症组，无并发症组。患者术后随访15.6~36.0个月，两组随访时间为(27.3±0.52)个月（有并发症）和(26.9±0.22)个月（无并发症）。两组年龄(7.5±0.2)岁和(7.0±0.5)岁。结果： 术后随访结果：共收集患者随访资料110例，无缺失，其中有并发症患者17例（15.5%），无并发症患者93例（84.5%）。手术成功率84.5%。两组手术随访时间、年龄无统计学差异（P>0.05）。单因素方差分析有差异性的指标为术前尿道开口的位置（P<0.01）、阴茎弯曲度（P<0.01）及尿道缺损长度（P=0.04），多因素分析采用二分类Logistic回归分析。结果显示仅阴茎弯曲度（OR=1.12，95%CI: 1.06~1.19，P<0.01）与术后并发症存在一定的关联性。结论： 对于初次尿道下裂患者，选择保留尿道板一期尿道下裂修复术，可取得良好效果。术前阴茎弯曲是初次尿道下裂患者术后并发症的独立危险因素，阴茎弯曲高的患者术后尿道下裂并发症越容易发生。.
Keywords: multiple linear regression analysis; hypospadias; urethroplasty; ventral penile curvature.