Dermal regeneration sheet Integra® in management of recurrent Urethrocutaneous fistula after hypospadias surgery
| Autor: | Miriam García González, María Alejandra García-Novoa, Iván Somoza Argibay, Isabel Casal-Beloy, Teresa Dargallo Carbonell, Lorena Míguez Fortes |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Urologic Surgical Procedures Male Adolescent Urinary Fistula Dartos Cutaneous Fistula Urology Fistula Foreskin 030232 urology & nephrology Physical examination 03 medical and health sciences Postoperative Complications 0302 clinical medicine Urethra Recurrence 030225 pediatrics Humans Regeneration Medicine Prospective Studies Child Skin Artificial Hypospadias medicine.diagnostic_test business.industry Chondroitin Sulfates Tunica vaginalis medicine.disease Surgery Catheter medicine.anatomical_structure Child Preschool Pediatrics Perinatology and Child Health Collagen business Complication Penis Follow-Up Studies |
| Zdroj: | Journal of Pediatric Urology. 15:634.e1-634.e6 |
| ISSN: | 1477-5131 |
| Popis: | Summary Background Urethrocutaneous fistula UCF is the most common complication following surgical repair of hypospadias. Currently, the surgical technique mostly used to prevent recurrence employs preputial dartos or testicular tunica vaginalis flaps as a urethral covering. However, autologous tissues are limited in patients with multiple surgeries, and the use of biomaterials as a urethral coverage may represent a good alternative. Objective The goal of the present study is to assess the results and complications of recurrent UCF correction using a dermal bovine regeneration sheet as a urethral covering. Materials and method From May 2016 to January 2019, all patients with recurrent UCF of the authors center were repaired using this technique. The inclusion criteria were patients who had undergone one or more unsuccessful UCF repair surgeries and the absence of preputial tissue. The informed consent has been signed by all the patients. Patients were examined in outpatient consultations where their urinary stream was evaluated and a physical examination of the penis was conducted. Results A total of 12 patients and 13 UCFs were included in the study. The median follow-up was 18 months, (range: 4–26), and only two patients (15%) developed a recurrence of UCF. No complications were observed in the remaining patients (85%) during their evolution. No patient developed a fibrosis increase or loss of elasticity of the tissues in contact with the dermal matrix. Conclusion The use of an Integra® sheet as a urethral covering during urethral fistula surgery appears to be a safe, effective, and easily reproducible option. However, prospective studies with larger numbers of patients should be performed to corroborate these results. Summary Table Patient Age (years) No. of fistulas Fistula size (mm) Days with catheter Monitoring time (months) Complications 1 5 1 3 mm 4 26 No 2 3 2 3 mm 7 26 No 4 mm 3 5 1 3 mm 4 25 No 4 6 1 3 mm 5 22 Fistula 5 10 1 3 mm 5 22 No 6 13 1 2 mm 2 22 No 7 9 1 3 mm 2 18 No 8 9 1 3 mm 2 18 No 9 7 1 3 mm 3 14 No 10 6 1 2 mm 5 14 Fistula 11 3 1 3 mm 5 14 No 12 3 1 3 mm 6 4 No |
| Databáze: | OpenAIRE |
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