Hipospadias cerrahisi sonrası gelişen meatus darlıklarının tedavisinde meatotomi dilatasyona göre daha başarılı mıdır?
Amaç: Yeni üretra dış meatusunda darlık, hipospadias cerrahisi sonrası en sık görülen komplikasyonlardan biridir. Tedavide meatotomi ve dilatasyon en yaygın kullanılan yöntemlerdir. Bununla birlikte, hangi tedavinin hangi sıra ile kullanılacağı veya tedavi algoritması konusunda yeterli bilgi bulunmamaktadır. Bu çalışmada hipospadias cerrahisi sonrası meatus darlığı gelişmiş olgularda kullanılan tedavi yöntemlerinin etkinlikleri karşılaştırmalı olarak değerlendirilmiştir. Gereç ve Yöntem: 2009-2019 yılları arasında, daha önce distal hipospadias nedeniyle ameliyat edilen ve meatus darlığı tanısı alarak genel anestezi altında meatotomi veya üretra dilatasyonu ile tedavi edilmiş olguların kayıtları geriye dönük olarak incelendi. Hastaların demografik özellikleri, hipospadias onarımında kullanılan ilk cerrahi yöntem, hipospadias onarımı sonrası meatus darlığı tedavisine kadar geçen süre, tedavi başarısı, nüks darlık tedavisinde kullanılan yöntem kaydedildi. Kontrollerde yakınması tekrar etmeyen olgular başarılı olarak tedavi edilmiş kabul edildi. statistiksel analiz için IBM- SPSS Statistics 23 programı yardımı ile Ki-kare, Student T ve Kolmogorov-Smirnov testleri kullanıldı. Bulgular: Çalışmaya dahil edilen 10 yıllık sürede, distal hipospadias cerrahisi sonrası meatus darlığı gelişen, yaş ortalaması 45,07 ± 36,60 ay olan 56 hasta saptandı. Meatus darlığı için yapılan işlem sayısı hasta başına ortalama 1,67±0,91 idi. Hipospadias onarımı ile meatus darlığı için ilk uygulanan tedavi arasındaki ortanca süre sırasıyla; meatotomide 25,97 ay, dilatasyon olgularında 13,72 aydı (p
Is meatotomy more successful than dilatation in the treatment of meatal stenosis developing after hypospadias surgery?
Aim: Stenosis in the external orifice of the neo-urethra is one of the most common complications after hypospadias surgery. Meatotomy and dilation are the most commonly used methods in the treatment of these cases. However, there is insufficient data about which treatment will be used in what order or the treatment algorithm. In this study, we aimed to evaluate the effectiveness of treatment methods used in patients with meatal stenosis after hypospadias surgery. Materials and Methods: Hospital records of patients who were operated for distal hypospadias and diagnosed with meatal stenosis and underwent meatotomy or urethral dilatation under general anesthesia were reviewed retrospectively between 2009-2019. The demographic data of the patients, the first surgical method used for hypospadias repair, the duration between the treatment of meatal stenosis and hypospadias repair, the success of the treatment and the method used in the treatment of recurrent stenosis were recorded. Patients whose complaints did not recur during controls were considered to have been successfully treated. Chi-square, Student T, and Kolmogorov-Smirnov tests were used for statistical analysis with help of IBS-SPSS Statistics 23 program. Results: In the 10-year period included in the study, 56 patients with a mean age of 45.07 ± 36.60 months developed meatal stenosis after distal hypospadias surgery. The mean number of procedures for meatal stenosis was 1.67 ± 0.91 per patient. The median duration between the hypospadias surgery and the first treatment for meatal stenosis was 25,97 months in meatotomy and 13,72 months in dilatation cases, respectively (p
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