Yasin AYDOĞMUŞ, Arif AYDIN, Tolga KARAKAN, MÜMTAZ DADALI, MUHAMMET ŞAHİN BAĞBANCI, Mücahit KABAR, Melih SUNAY, Ahmet Metin HASÇİÇEK, Erim ERSOY, R. Cankon GERMİYANOĞLU

Proksimal hipospadyaslı olgularda TIP üretroplasti sonuçları

Amaç: Proksimal hipospadyaslı primer vakalarda uygulanan tubularized incised plate üretroplasti (TIPU) tekniğinin klinik sonuçlarının değerlendirilmesini amaçladık. Yöntemler: Kliniğimizde 20032011 tarihleri arasında, eksternal üretral meatusu proksimal penil veya penoskrotal seviyede olan ve TIPU tekniğiyle onarım yapılan 33 primer hipospadyaslı vaka geriye dönük olarak değerlendirildi. Ameliyat sonrası fistülsüz işeme başarı olarak değerlendirildi. Bulgular: Hastaların ortalama yaşı 6,82±3,07 (113) idi. Hastaların 15inde (%45,4) penoskrotal, 18inde (%54,6) proksimal penil seviyede izlenen üretral meatus bulunmaktaydı. Hastalar üretral kateter çekildikten hemen sonra, taburcu edildikten 2 hafta ve 6 ay sonra idrar yaparken gözlemlenerek değerlendirildiler. İlk operasyon sonrası penoskrotal seviyede 5/15, proksimal penil seviyede 10/18 oranlarında fistülsüz işeme sağlandı; ilk operasyonlar sonrası genel başarı %45,5ti. Fistüllü işeyen hastalara yapılan ikinci operasyon ile bu oranlar penoskrotal seviyede 9/15, proksimal penil seviyede ise 16/18e yükselmiş; total başarı oranı ise %75,8 bulunmuştur. Sonuç: Günümüzde ileri derecede kordisi olmayan proksimal hipospadyas olgularında üretral plate gelişiminde önemli bir bozukluk yoksa TIPU tekniği, deneyimli merkezlerde güvenle tercih edilebilecek bir yöntemdir.

Tubularized incised plate urethroplasty results in patients with proximal hypospadias

Objective: To evaluate the results of the patients with primary proximal hypospadias repaired by tubularized incised plate urethroplasty (TIPU). Methods: Thirty-three patients who were operated with TIPU technique in our clinic between 2003-2011 for primary hypospadias with proximal penile and penoscrotal meatus were retrospectively evaluated. Evaluation of the success in this study was, voiding without fistula. Results: Mean age was 6.82±3.07 (1-13). Fifteen patients (45.4%) had penoscrotal and 18 patients (54.6%) had proximal penil meatus. Postoperative success was evaluated with direct vision of voiding at the time of uncatheterization, 2 weeks and 6 months after un-catheterization. Success rates were 5/15 and 10/18 after the first repair in the level penoscrotal and proximal penil, respectively. Overall success rate was 45.5% after the first repair. Patients with urethral fistula after first repair were undergone second repair, success rates were increased to 9/15 and 16/18 in the levels of penoscrotal and proximal penil, respectively. Overall success rate after second repair was 75.8%. Conclusion: TIPU may be confidently applied for the patients with proximal hypopadias in experienced clinics, if there is not an uretral cordi or/and abnormality in the development of urethral plate.

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