Application of the modified Byars staged procedure for severe hypospadias repair  

作　　者：Qi-Gen Xie Ting-Ting Xue Xu-Ren Chen Zhao-Ying Li Zhe Xu Zuo-Qing Li Peng Luo 

机构地区：[1]Department of Pediatric Surgery,The First Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510080,China [2]Department of Thoracic Surgery,Guangzhou Womenand Children’s Medical Center,Guangzhou Medical University,Guangzhou 510620,China [3]Reproductive Medicine Center,The Key Laboratory for Reproductive Medicineof Guangdong Province,The First Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510080,China

出　　处：《Asian Journal of Andrology》2025年第1期65-71,共7页亚洲男性学杂志(英文版)

基　　金：supported by funding from the Medical Research Funding of Guangdong(No.A2022499 to QGX);the National Natural Science Foundation of China(No.82301796 to PL);the Guangdong Province Regional Joint Fund-Youth Fund Project of China(No.2022A1515111201 to PL).

摘　　要：This study aimed to introduce a modified Byars staged procedure and investigate its application value in patients with severe hypospadias.We retrospectively analyzed the clinical data of patients with severe hypospadias admitted to the First Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between October 2012 and October 2022.In total,31 patients underwent the conventional Byars procedure(conventional group),and 45 patients underwent the modified Byars staged procedure(modified group).Our modified strategy was built upon the standard Byars procedure by incorporating glansplasty during the first stage and employing a Y-shaped flap in conjunction with a glandular tunnel for urethroplasty during the second stage.Notably,there were no statistically significant differences in the preoperative baseline characteristics,duration of surgery,amount of blood loss,or occurrence of postoperative complications,including urethral fistula,stricture and diverticulum,or penile curvature,between the conventional and modified groups.However,there was a significantly lower incidence of coronal sulcus fistula(0 vs 16.1%,P=0.02)and glans dehiscence(0 vs 12.9%,P=0.02)in the surgical group than that in the conventional group.In addition,the modified group exhibited a notably greater rate of normotopic urethral opening(100.0%vs 83.9%,P=0.01)and a higher mean score on the Hypospadias Objective Penile Evaluation(HOPE;mean±standard error of mean:8.6±0.2 vs 7.9±0.3,P=0.02)than did the conventional group.In conclusion,the modified Byars staged procedure significantly reduced the risks of glans dehiscence and coronal sulcus fistula.Consequently,it offers a promising approach for achieving favorable penile esthetics,thereby providing a reliable therapeutic option for severe hypospadias.

关 键 词：byars glans dehiscence severe hypospadias staged procedure TUNNEL URETHROPLASTY 

分 类 号：R69[医药卫生—泌尿科学]