Volume 4,Issue 3
Application of Distal Urethral Mobilization in the Duckett Procedure for Hypospadias
Objective: To investigate the value of distal urethral mobilization in the Duckett procedure. Methods: A retrospective analysis was conducted on 96 children with hypospadias treated between January 2017 and June 2023. Patients were divided into an observation group (52 cases) and a control group (44 cases) based on whether distal urethral mobilization was performed intraoperatively. The neourethral length, operative time, postoperative complications, maximum urinary flow rate (Qmax), and HOSE scores were compared between the two groups. Results: The neourethral length in the observation group was shorter than that in the control group [(2.4 ± 0.6) cm vs. (3.3 ± 0.7) cm, p < 0.001], while operative time was comparable between the two groups (p = 0.077). The overall complication rate [21.2% vs. 59.1%], urethrocutaneous fistula rate [9.6% vs. 25.0%], and reoperation rate [7.7% vs. 27.3%] were all lower in the observation group than in the control group (p < 0.001, 0.044, 0.010). Among those followed up for at least 12 months, the observation group demonstrated superior Qmax [(13.1 ± 2.9) mL/s vs. (11.4 ± 3.0) mL/s] and HOSE scores [(15.2 ± 1.4) vs. (13.8 ± 2.1)] compared with the control group (p = 0.020, p < 0.001). Conclusion This technique shortens the neourethral length, reduces the risk of urethrocutaneous fistula and reoperation, and improves midterm voiding function.
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