影响尿道下裂手术决策和预后的相关因素的研究进展

Analysis of factors related to the surgical decision-making and prognosis of hypospadias

目的尿道下裂是泌尿生殖系统常见的先天性畸形之一,手术是最有效的治疗方式。本文基于目前临床治疗指南、临床常用术式的手术治疗随访研究结果,针对研究中存在的一些争议,包括不同类型尿道下裂的治疗选择、复杂情况下手术方案的确定、是否应用激素联合手术治疗、一期手术与多期手术的抉择等,围绕手术方式、手术年龄、手术史、阴茎尿道情况等,探讨以上因素对尿道下裂手术术后并发症总体发生率的影响。其中,阴茎头大小、尿道板的宽度、阴茎弯曲度都是影响尿道下裂预后的危险因素,目前尚无明确证据表明术前雄激素刺激会对预后产生不良影响,对于复杂性尿道下裂,现有研究更倾向于分期手术。

Hypospadias is one of the common congenital abnormalities in the genitourinary system,and surgery is the most effective treatment.This article is based on currently available clinical treatment guidelines and follow-up studies of commonly used surgical procedures.It addresses some controversies in the research,including the choice of treatment for different types of hypospadias,surgical plans in complex cases,the use of hormone-assisted surgery,and the decision between one-stage and multiple-stage surgeries and so on.The impact of surgical methods,age at surgery,surgical history,and penile urethral conditions on the overall incidence of postoperative complications in hypospadias surgery is explored.Factors such as glans size,width of the urethral plate,and penile curvature are risk factors affecting prognosis.Currently,there is no clear evidence indicating that preoperative androgen stimulation has adverse effects on prognosis.For complex hypospadias cases,existing research tends to favor staged surgeries.