For a study, researchers sought to determine the variables that affect urethroplasty success in DSD patients and to offer some guidelines for the surgical management of Disorders (or differences) of Sex Development (DSD) patients having urethroplasty. They retrospectively examined DSD patients who underwent urethroplasty between January 2016 and December 2019. Patients were split into 4 categories: the group that had successful surgery; the groups with urethrocutaneous fistulas; the groups with urethral diverticula; and the groups with urethral strictures. The DSD classification, the age of the first operation, the length of the urethral defect, the severity of hypospadias, cryptorchidism, micropenis, gonad type, hormone therapy before the operation, the transposition of the penis and scrotum, the surgical approach, the urethral covering material, and the length of time after the procedure before the catheter was removed were all used to identify risk factors. By comparing single factor and multifactor logistic regression analyses of related factors, they looked at how each factor varied between the 4 groups. The length of the urethral defect was a separate risk factor for urethroplasty patients with a disorder of sex development that affects both the outcome of the procedure and the development of a urethrocutaneous fistula. About 12 of the 122 cases (n=122) in this group were not followed up on. A 28-month median follow-up (12–55 months). They discovered that a longer urethral defect resulted in a worse success rate for surgery (B=-0.473, P=0.005). The success rate of operations was higher for staged operations and TPIT-related operations than for primary operations (B=1.238, P=0.006) and TPIT-unrelated operations (B=2.293, P=0.001). Although there was no significant difference in the logistic regression analysis between the age of the first operation and the occurrence of urethrocutaneous fistula (P=0.161>0.05), there was a significant difference between these two variables (P=0.006<0.05). In TPIT-related operations compared to TPIT-unrelated operations, urethrocutaneous fistula incidence was reduced (B=-2.507, P=0.000). In contrast to the main surgery, phased surgery had a decreased incidence of the postoperative urethral diverticulum (B=-1.737, P=0.015). The initial operation’s age had a statistically significant impact on the occurrence of postoperative urethrocutaneous fistula, although it is not a standalone risk. In the study, TPIT-related operations had a lower incidence of urethrocutaneous fistula. Comparing a staged operation to a 1-stage operation provided an independent protective factor for postoperative urethral diverticulum, although neither was connected to urethrocutaneous fistula.

 

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-022-01080-x