Urinary flow measurement in hypospadias correlated to surgical procedure and risk of development of urethra-cutaneous fistula

Winberg, Hans; Anderberg, Magnus; Arnbjörnsson, Einar; Stenström, Pernilla

doi:10.1016/j.jpurol.2020.03.004

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…Предложенная методика аугментации уретральной площадки на головке и в дистальной части уретры не относится к оригинальной операции, подобные подходы имплантации широких квадратных лоскутов уже давно и успешно проводят при этапных операциях коррекции проксимальной и осложненной гипоспадии [18][19][20].…”

Section: Discussionunclassified

“…Метод помогает максимально уменьшить риски стеноза уретры в случае рубцевания тканей в области меатуса и предупредить нарушение потока мочи. Существует мнение, что снижение потока мочи не оказывает влияния на возникновение свища уретры [20][21][22]. Однако мы полагаем, что широкий мочеиспускательный канал и свободное мочеиспускание обеспечивают более благоприятное заживление сформированной уретры и снижают опасность возникновения свищей уретры [23].…”

Section: Discussionunclassified

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Augmentation of the urethral plate in the glans penis area and the distal urethra – effective method of fistula correction in children with hypospadias

Рудин

Марухненко²,

Рудин

et al. 2021

Androl. genit. hir.

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Background. Important causes of complications of hypospadias repair are the deficit of tissues for plastic surgery, grooveless and small size of glans, obliteration of the urethral platewith varying degrees of scarring. The coronal urethral fistula is the most common complication of urethroplasty. Surgeons continue to search for reliable methods of correction of complications.Materials and methods. Between 2011 and 2019, 85 children aged 2 and 17 years presented with coronal fistula of urethra after hypospadias repair. (TIP) Snodgrass – 78 (91.7 %) and Mathiue – 7 (8.2 %) procedures have been performed them earlier. In our clinic previously operated 28 (32 %) boys, primary surgery of the remaining 57 (67 %) was performed in other medical institutions.Results. All patients (85), conditionally, were divided into two groups. The first group included 39 children (45.8 %), with stitching a fistula, the second group consisted of 46 patients (54.1 %), with augmentation of the urethral plate of the glans and distal urethra with the implantation of a rectangular preputial or oral mucosa free graft. Recurrent urethral fistula after stitching was observed in 10 boys (25.6 %) of the first group, and only in 2 cases (4.3 %) in children with the augmentation of the urethral plate (p <0.05). The decrease of urine flow according to the data of uroflowmetry was observed in 15 patients (52 %) the first group, the children of the second group did not have a decrease in the flow of urine.Discussion. The shape, size of the glans and the condition of the urethral plate affect to the result of urethroplasty. The connection of the wings of the glans in accordance with normal anatomy, avoid obstruction in the distal part of urethra. A wide urethra in the glans and meatal area improves urine flow. Conclusion. The augmentation of the urethral plate of the penile glans and the distal urethra with the implantation of a wide rectangular free flap in to the meatus, in our opinion, an advantage over the implantation of diamond-shaped grafts using the GTIP or TIP graft technique.

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Section: Discussionunclassified

Augmentation of the urethral plate in the glans penis area and the distal urethra – effective method of fistula correction in children with hypospadias

Рудин

Марухненко²,

Рудин

et al. 2021

Androl. genit. hir.

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“…We further excluded 12 with the NRSIs only used for incidence of adverse events or did not include both RCTs and NRSIs within a meta-analysis. Of the remaining 75 systematic reviews, 31 were eligible, which had at least one outcome, contained both RCTs and NRSIs, and provided summarized 2 x 2 table data for each study in the meta-analysis (Grootscholten et al, 2008;Sun et al, 2008;Torloni et al, 2009;Touzé et al, 2009;Slobogean et al, 2010;Yaghoobi et al, 2010;Aires et al, 2015;Geng et al, 2015;Ghayoumi et al, 2015;Inokuchi et al, 2015;Wang et al, 2015;Yoon et al, 2015;Zhang and Ma, 2015;Keir et al, 2016;Peng et al, 2016;Vavken et al, 2016;Balasubramanian et al, 2017;Geminiani et al, 2017;Pecorelli et al, 2017;Cheng et al, 2018;Shah et al, 2018;Zhao et al, 2018;Ceresoli et al, 2019;Craveiro et al, 2019;Jiang et al, 2019;Menne et al, 2019;Nagy et al, 2019;Shah et al, 2019;Vaos et al, 2019;Winberg et al, 2019;Yang et al, 2019). The selection process is reported in Supplementary Figure S1, and the characteristics of the included systematic reviews are shown in Supplementary Table S1.…”

Section: Basic Characteristicsmentioning

confidence: 99%

An empirical comparison of the harmful effects for randomized controlled trials and non-randomized studies of interventions

et al. 2023

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Introduction: Randomized controlled trials (RCTs) are the gold standard to evaluate the efficacy of interventions (e.g., drugs and vaccines), yet the sample size of RCTs is often limited for safety assessment. Non-randomized studies of interventions (NRSIs) had been proposed as an important alternative source for safety assessment. In this study, we aimed to investigate whether there is any difference between RCTs and NRSIs in the evaluation of adverse events.Methods: We used the dataset of systematic reviews with at least one meta-analysis including both RCTs and NRSIs and collected the 2 × 2 table information (i.e., numbers of cases and sample sizes in intervention and control groups) of each study in the meta-analysis. We matched RCTs and NRSIs by their sample sizes (ratio: 0.85/1 to 1/0.85) within a meta-analysis. We estimated the ratio of the odds ratios (RORs) of an NRSI against an RCT in each pair and used the inverse variance as the weight to combine the natural logarithm of ROR (lnROR).Results: We included systematic reviews with 178 meta analyses, from which we confirmed 119 pairs of RCTs and NRSIs. The pooled ROR of NRSIs compared to that of RCTs was estimated to be 0.96 (95% confidence interval: 0.87 and 1.07). Similar results were obtained with different sample size subgroups and treatment subgroups. With the increase in sample size, the difference in ROR between RCTs and NRSIs decreased, although not significantly.Discussion: There was no substantial difference in the effects between RCTs and NRSIs in safety assessment when they have similar sample sizes. Evidence from NRSIs might be considered a supplement to RCTs for safety assessment.

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Concomitant Repair of Meatal Stenosis and Urethral Fistula Does Not Increase the Risk of Fistula Recurrence Post Hypospadias Surgery

Bar-Yosef

Ben‐Chaim

Ekstein

et al. 2022

Urology

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Urinary flow measurement in hypospadias correlated to surgical procedure and risk of development of urethra-cutaneous fistula

Cited by 4 publications

References 22 publications

Augmentation of the urethral plate in the glans penis area and the distal urethra – effective method of fistula correction in children with hypospadias

Augmentation of the urethral plate in the glans penis area and the distal urethra – effective method of fistula correction in children with hypospadias

An empirical comparison of the harmful effects for randomized controlled trials and non-randomized studies of interventions

Concomitant Repair of Meatal Stenosis and Urethral Fistula Does Not Increase the Risk of Fistula Recurrence Post Hypospadias Surgery

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