Comparison of short-term complications between Onlay and Duckett urethroplasty and the analysis of risk factors

Lyu, Yiqing; Yu, Ling; Xie, Hua; Huang, Yichen; Li, Xiaoxi; Sun, Li; Bao, Jie-Wen; Liu, Yan; Zhou, Xiaocheng; Chen, Fang

doi:10.1007/s11255-019-02125-1

Cited by 12 publications

(13 citation statements)

References 13 publications

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“…Up to now, TIP has become the most commonly used technique for the treatment of proximal and middle hypospadias, and it is the most popular procedure in Europe ( 15 , 16 ). In 1980 and 1987, Duckett successively performed the Duckett and Onlay surgical procedures, in which the newly formed urethra was composed entirely or with the involvement of the prepuce inner plate with a vascularized pedicle, which greatly improved the primary cure rate of patients with hypospadias ( 17 , 18 ). Although the surgical methods of hypospadias are constantly improving and evolving, there is still no surgical procedure that can be used as the gold standard for all types of hypospadias.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of C-Reactive Protein for Early Postoperative Complications in Children After Hypospadias Surgery

Tang

et al. 2021

Front. Pediatr.

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Background: This study explored the predictive value of postoperative C-reactive protein in children with hypospadias for postoperative complications and the risk factors.Methods: The clinical and follow-up data of 106 children with hypospadias who were treated with operations at Kunming Children's Hospital in 2020 were, respectively, analyzed. According to the occurrence of postoperative complications, the patients were divided into two groups: 25 patients with postoperative complications were the complications group, and 81 without postoperative complications were the control group. The baseline data, clinical characteristics, laboratory test indexes, and outcome of the two groups were collected. Receiver operating characteristic (ROC) was used to calculate the optimal cutoff value of C-reaction protein (CRP). Logistic regression was used to analyze the risk factors of hypospadias after surgery. A probability value (P) < 0.05 was considered statistically significant.Results: According to the result of the ROC curve, the optimal cutoff value of CRP was 11.7 mg/L. Logistic regression showed that the length of urethral defect, the urethral material, the operative produce, and the postoperative CRP level were related to the occurrence of postoperative complications of patients with DCC. The length of the urethral defect and the CRP level were the independent risk factors of the prognosis of hypospadias patients. The CRP level was related to the occurrence of postoperative complications and fistula.Conclusions: Postoperative CRP level can be used as a reliable marker for predicting the prognosis of hypospadias patients.

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Section: Discussionmentioning

confidence: 99%

Predictive Value of C-Reactive Protein for Early Postoperative Complications in Children After Hypospadias Surgery

Tang

et al. 2021

Front. Pediatr.

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“…Apart from the procedures noted above, we improved the technique while making the anastomosis between the tubularized flap and original urethral meatus. Owing to the intersection of different tissues, the anastomosis between neourethra and native urethral meatus is with a tendency of stenosis [ 23 ]. Bevel incision was sufficient and large enough, and then we make the anastomosis by interrupted sutures, in order to release the tension.…”

Section: Discussionmentioning

confidence: 99%

A new modified Duckett urethroplasty for repair of proximal hypospadias with severe chordee: outcomes of 133 patients

Wang

Zhang

et al. 2022

BMC Urol

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Background Despite the continuous development and evolution of surgical methods and techniques, proximal hypospadias remains one of the most challenging issues for pediatric urologists. This study aims to evaluate the indications and postoperative complications of our new modified Duckett urethroplasty. Methods A total of 133 patients with proximal hypospadias who underwent repair of the modified Duckett urethroplasty from February 2016 to February 2021 were reviewed. The median age of patients was 3 years (range 1–16). All patients had severe chordee. One senior experienced pediatric urologist performed all the surgeries. Catheter was removed 14 days after the surgery. Results The location of the urethral meatus was proximal penile in 26 patients (19.5%), penoscrotal in 60 (45.1%), scrotal in 31 (23.3%), and perineal in 16 (12.0%). The mean length of the urethral defect was 4.5 cm (range 2.5–10). The median duration of follow-up was 46 months (range 8–67). Complications occurred in 31 patients (23.3%), including urethra-cutaneous fistula in 22 (16.5%), urethral stenosis in 7 (5.3%), and urethral diverticulum in 2 (1.5%). No recurrent chordee were found in all cases. All patients who developed complications were treated successfully at our hospital. Conclusions Our modified Duckett urethroplasty showed functionally and cosmetically favorable outcomes, with a lower incidence of postoperative complications. To the best of our knowledge, the novel Duckett technique is a feasible and suitable option for patients who suffer from proximal hypospadias with severe chordee and dysplasia of the urethral plate.

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“…Therefore, a planned and proactive staging option is a reasonable decision, especially in the case of heavy hypospadias, where the choice may not be between staging and staging, but between active and passive staging [ 10 ]. If there is a planned choice of the staged surgery, the requirements of its first phase should not be limited to some specific corrective elements, but should be understood as creating good corrective conditions for the second phase of surgery [ 11 ]. In addition to completely correcting the hypospadias, the first stage of surgery allows for partial reconstruction of the urethra where appropriate, reducing the length of the urethra repaired during the second stage, and reducing the risk of each stage of the surgery [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

The Effect of the Duckett procedure on the Outcome and Prognosis of Children with Suburethral Cleft

Geng

Cheng

Yang

et al. 2022

Contrast Media & Molecular Imaging

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Background. Hypospadias is one of the most common malformations of the male genitourinary system. In recent years, the incidence of hypospadias is increasing year by year, which seriously affects normal urination and sexual function. Repairing hypospadias has always been a challenge in paediatric urology, requiring a variety of surgical techniques and science and art that requires intensive study. Despite the availability of over 300 surgical procedures and continuous improvement, there is still a high level of surgical complications. It is crucial to choose an appropriate and effective surgical method for the treatment of hypospadias. Aims. This study aimed to investigate the outcome and prognosis of children with hypospadias, using transverse cut foreskin island flap coiled urethroplasty (the Duckett procedure). Materials and Methods. A retrospective study was conducted on 100 children with hypospadias who underwent surgery in our hospital from December 2018 to December 2021. Based on the degree of hypospadias and the degree of penile curvature both in line with the Duckett procedure, the comparison group was treated with a one-stage Duckett procedure and the treatment group was treated with a staged Duckett procedure. The differences in the surgical condition, inflammatory factor levels, and complications between the two groups of children were observed and compared. Results. The length of hospital stay and VAS score in the treatment group were significantly lower than those in the control group, and the operation time and intraoperative bleeding were higher than those in the control group, with a statistical significance ( P < 0.05 ). The success rate of one operation was higher than that of the comparison group, but the statistical comparison was not statistically significant ( P > 0.05 ). There was no statistically significant difference in the inflammatory response between the two groups before surgery ( P > 0.05 ), while the difference in CRP, IL-6, and calcitoninogen between the two groups after surgery was significant and lower in the comparison group than in the treatment group, which was statistically significant ( P < 0.05 ). The clinical outcome of the children in both groups showed that the excellent rate of 92.00% in the treatment group was significantly higher than that of 74.00% in the comparison group, while the incidence of complications was significantly lower than that of the comparison group, and the difference was statistically significant ( P < 0.05 ). Complications in children with poor surgical outcomes in both groups occurred mainly, early urethral stricture and cured by urethral dilatation or condition without improvement cured by urethrotomy. Conclusion. A comparative study of hypospadias treated with the staged Duckett procedure was more effective in relieving postoperative pain and inflammatory reactions in children, reducing postoperative complications and improving healing efficiency, providing some reference value for hypospadias surgery.

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Comparison of short-term complications between Onlay and Duckett urethroplasty and the analysis of risk factors

Cited by 12 publications

References 13 publications

Predictive Value of C-Reactive Protein for Early Postoperative Complications in Children After Hypospadias Surgery

Predictive Value of C-Reactive Protein for Early Postoperative Complications in Children After Hypospadias Surgery

A new modified Duckett urethroplasty for repair of proximal hypospadias with severe chordee: outcomes of 133 patients

The Effect of the Duckett procedure on the Outcome and Prognosis of Children with Suburethral Cleft

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