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

  • Urology - Original Paper
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Abstract

Aims

To compare the short-term complications between Onlay and Duckett urethroplasty and to analyze the various risk factors cause the complications.

Methods

The children with hypospadias who underwent treatment with Onlay or Duckett urethroplasty from November 2014 to June 2016 were followed up. The difference in complications between the two groups was analyzed. Moreover, a single-factor ANOVA was performed to analyze the length and curvature of the penis and the length of the urethral defect.

Results

40 patients were treated by Duckett, while 54 by Onlay. In comparison to the Onlay group, the Duckett group showed the initial penile length was shorter (P = 0.044), the initial urethral defect (P = 0.024) and after the correction of chordee was longer (P < 0.001), and the initial penile curvature (P < 0.001) and after degloving (P < 0.001) was greater. Furthermore, the incidence of urethra percutaneous fistula (P = 0.041) and urethral stenosis (P < 0.001) in Duckett group was significantly higher. The analysis of risk factors showed that the age at the time of surgery, the initial penile curvature, the initial urethral defect, and the urethral defect after the correction of chordee were not correlated with the complications. The degree of penile curvature after skin degloving and urethra stenosis was significantly correlated (P = 0.019).

Conclusion

The incidence of complications of urethra percutaneous fistula and urethral stenosis after 1 year of Duckett was higher than that by Onlay approach. The greater the curvature of the penis after skin degloving, the more likely the occurrence of urethral stenosis after surgery.

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Acknowledgements

This work was part of the Program on ‘Reconstruction of glans with dysplastic urethral cavernosum and Buck’s fascia to reduce the complication rate of fistula at coronal sulcus and dehiscence after hypospadias repair’ funded under the Science and Technology Commission of Shanghai Municipality, Grant number 15411966900. This work was also part of the Program on ‘Multicenter clinical study on standardized diagnosis and treatment of severe urinary tract malformations in neonates’ funded under the Science and Technology Commission of Shanghai Municipality for Medicine and Agriculture Program, Grant Number 14411950403. The authors are grateful to all study participants.

Funding

The study supported by Program on ‘Reconstruction of glans with dysplastic urethral cavernosum and Buck’s fascia to reduce the complication rate of fistula at coronal sulcus and dehiscence after hypospadias repair’ was funded under the Science and Technology Commission of Shanghai Municipality (Grant Number 15411966900). And Program on ‘Multicenter clinical study on standardized diagnosis and treatment of severe urinary tract malformations in neonates’ funded under the Science and Technology Commission of Shanghai Municipality for Medicine and Agriculture Program (Grant Number 14411950403).

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Author notes

  1. Yiqing Lyu and Lin Yu have contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai, 200040, China

    Yiqing Lyu, Ling Yu, Hua Xie, Yichen Huang, Xiaoxi Li, Li Sun, Jiewen Bao, Yan Liang & Fang Chen

  2. Department of Bioinformatics and Biostatistics, Center for Biomedical informatics, Shanghai Jiaotong University, Shanghai Children’s Hospital, Shanghai, China

    Xiaocheng Zhou

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  1. Yiqing Lyu
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  2. Ling Yu
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  3. Hua Xie
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  4. Yichen Huang
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  8. Yan Liang
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Contributions

YL, LY, and FC carried out the studies, participated in collecting data, and drafted the manuscript. HX, YH, XL, LS, and XZ performed the statistical analysis and participated in its design. JB and YL helped to draft the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Fang Chen.

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Conflict of interest

All authors declare that they have no conflict of interests.

Ethical approval

Ethical approval was given by the medical ethics committee of Shanghai Children’s Hospital.

Informed consent

All the patients and their families were informed of the study purpose of the experiment, and signed the informed consent form.

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Lyu, Y., Yu, L., Xie, H. et al. Comparison of short-term complications between Onlay and Duckett urethroplasty and the analysis of risk factors. Int Urol Nephrol 51, 783–788 (2019). https://doi.org/10.1007/s11255-019-02125-1

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  • DOI: https://doi.org/10.1007/s11255-019-02125-1

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