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Hipospadias Onarımında Snodgrass Yönteminin Başarısını Etkileyen Faktörler

Factors Effecting Success of Snodgrass Technique in Hypospadias Repair

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Abstract (2. Language): 
In recent years Snodgrass technique has gained widespread acceptance for repairing hipospadias. In this study we aimed to discuss demographic charasteristics, complications, effectiveness of Snodgrass procedures of 85 patients. Patients operated before september 2000 were named as Group A (n:28), and those operated after this date were named as Group B (n:57). In group A,urethroplasty was done using 7/0 PDS full thickness continious sutures. In group B subcuticular sutures were used. Dorsal vascularized dartos subcutaneous flep used for water proof layer. Ratios of postoperative complications in group A as followed; 7% ürethral fistula (n:6) and 5.8 % meatal stenosis (n:5) responded to dilatation. There was no complication in Group B. In all of the patients satisfactory cosmetic results vere obtained. Our findings indicate that Snodgrass procedure is an easy procedure to perform in the distal, midpenile, and penoscrotal hypospadias cases. Snodgrass procedure is also suitable in re-do hypospadias cases. As experience improved complications such as fistula and meatal stenosis were seen rarely.
Abstract (Original Language): 
Son yıllarda hipospadias onarımında Snodgrass yöntemi (TIPU – tubularized incised plate urethroplasty) geniş bir kabul görmüştür. Bu çalışmada Snodgrass yöntemi ile onarım yapılan 85 hastanın demografik özellikleri, yöntemin başarısını ve komplikasyonları etkileyen faktörler retrospektif olarak değerlendirilmiştir. Eylül 2000’e kadar opere edilenler Grup A (n:28), sonrakiler Grup B (n:57) olarak ikiye ayrıldı. Üretroplasti Grup A’daki 28 hastada 7/0 polydioxanone (PDS) ile kontinü tam kat sütürlerle yapılırken, Grup B’de ki 57 hastada kontinü subcutikuler sütürlerle yapıldı. Tek kat sütürlerin üzerine vaskularize dorsal dortos subkutanöz flep getirildi. A grubundaki 6 olguda fistül (% 7), 5 olguda da dilatasyonlara cevap veren meatal stenoz (% 5.8) gelişti. Grup B deki olgularda komplikasyon gözlenmedi. Olguların tümünde memnuniyet verici kozmetik görüntü elde edildi. Hipospadias onarımında Snodgrass yöntemi; distal, midpenil ve penoskrotal mea yerleşimli veya sekonder olgularda da uygulanabilecek uygulanması kolay bir onarım tekniğidir. Deneyim arttıkça fistül ve stenoz gibi komplikasyonlar daha seyrek olarak görülmektedir.
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