临床小儿外科杂志Issue(2)：113-116,129,5.DOI:10.3969/j.issn.1671-6353.2015.02.009
尿道下裂术后反复尿路感染原因分析
Recurrent urinary tract infections after hypospadias repair in children
摘要
Abstract
Objective To discuss the causes of recurrent urinary tract infections (UTIs)in boys who have undergone hypospadias repair. Methods A retrospective analysis was made on the records of all boys who had recurrent UTIs after primary or redo tubularized incised plate (Snodgrass)or transverse island flap (Ducket)repairs,from 2004 to 2014.Data on age,operating details,postoperative complications and imaging studies were collected.We attempted to identify risk factors for recurrent UTIs after hypospadias repair. Re-sults During the study period,43 /449 boys (1.91%)were diagnosed with recurrent UTIs after hypospadias repair.The boys′mean (range)age at repair was 14 (6 ~24)months and the median (range)follow-up was 6.5 (1.5 ~11)years.Primary Snodgrass and Ducket were performed in 47% (20 /43)and 35% (15 /43)of the boys,respectively.Redo surgeries were performed in 18% of the boys (8 /43).The initial meatal location was proximal in all Ducket and redo repairs,and in one of the Snodgrass repairs.Postoperative voiding cysto -urethrography,ultrasonography and dimercapto -succinic acid (DMSA)scans were performed in 58% (25 /43),90% (39 /43)and 19% (8 /43)of the boys,respectively.Abnormalities were noted.Of those boys who underwent a Ducket repair,urethral diverticula were seen in 47% (7 /15)and urethral fistulae were also seen in 47% (7 /15).Conversely,in those who had a Snodgrass repair,an elevated PVR and vesico-ureteric reflux were more common;they were found in 40% (8 /20)and 50% (10 /20)of patients,respectively. Conclu-sions The pathophysiology of recurrent UTI is multifactorial,but postoperative complications seem to vary with type of procedure.Recurrent UTIs after hypospadias surgery should prompt a specific assessment for potentially functionally relevant and correctable anatomical abnormalities.关键词
尿道下裂/再手术/感染/儿童Key words
Hypospadias/Reoperation/Infection/Child引用本文复制引用
刘波,王霞,陈勇,陈太忠,李光亮,谭长春..尿道下裂术后反复尿路感染原因分析[J].临床小儿外科杂志,2015,(2):113-116,129,5.基金项目
重庆市卫生局2013年医学科研计划项目 （）
