The Effect of the Duckett procedure on the Outcome and Prognosis of Children with Suburethral Cleft

Abstract

Background. Hypospadias is one of the most common malformations of the male genitourinary system. In recent years, the incidence of hypospadias is increasing year by year, which seriously affects normal urination and sexual function. Repairing hypospadias has always been a challenge in paediatric urology, requiring a variety of surgical techniques and science and art that requires intensive study. Despite the availability of over 300 surgical procedures and continuous improvement, there is still a high level of surgical complications. It is crucial to choose an appropriate and effective surgical method for the treatment of hypospadias. Aims. This study aimed to investigate the outcome and prognosis of children with hypospadias, using transverse cut foreskin island flap coiled urethroplasty (the Duckett procedure). Materials and Methods. A retrospective study was conducted on 100 children with hypospadias who underwent surgery in our hospital from December 2018 to December 2021. Based on the degree of hypospadias and the degree of penile curvature both in line with the Duckett procedure, the comparison group was treated with a one-stage Duckett procedure and the treatment group was treated with a staged Duckett procedure. The differences in the surgical condition, inflammatory factor levels, and complications between the two groups of children were observed and compared. Results. The length of hospital stay and VAS score in the treatment group were significantly lower than those in the control group, and the operation time and intraoperative bleeding were higher than those in the control group, with a statistical significance ( $P<0.05$ ). The success rate of one operation was higher than that of the comparison group, but the statistical comparison was not statistically significant ( $P>0.05$ ). There was no statistically significant difference in the inflammatory response between the two groups before surgery ( $P>0.05$ ), while the difference in CRP, IL-6, and calcitoninogen between the two groups after surgery was significant and lower in the comparison group than in the treatment group, which was statistically significant ( $P<0.05$ ). The clinical outcome of the children in both groups showed that the excellent rate of 92.00% in the treatment group was significantly higher than that of 74.00% in the comparison group, while the incidence of complications was significantly lower than that of the comparison group, and the difference was statistically significant ( $P<0.05$ ). Complications in children with poor surgical outcomes in both groups occurred mainly, early urethral stricture and cured by urethral dilatation or condition without improvement cured by urethrotomy. Conclusion. A comparative study of hypospadias treated with the staged Duckett procedure was more effective in relieving postoperative pain and inflammatory reactions in children, reducing postoperative complications and improving healing efficiency, providing some reference value for hypospadias surgery.