Comparison of effect between dartos fascia and tunica vaginalis fascia in TIP urethroplasty: a meta-analysis of comparative studies

BMC Urology

Qiang Shu¹  Jun-fen Fu¹  Xiao-xiao Xuan¹  Xiao-dong Guo²  Dong-lai Hu²  Hao Yang³  Hang Zhang³ 

[1] Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China;National Clinical Research Center for Child Health, Hangzhou, China;Department of Pediatric Surgery, Zhejiang University Jinhua Hospital, Jinhua, China;Zhejiang University School of Medicine, Hangzhou, China;Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China;National Clinical Research Center for Child Health, Hangzhou, China;

关键词: Hypospadias;    Urethrocutaneous fistula;    Dartos fascia;    Tunica vaginalis fascia;    Meta-analysis;   

DOI  :  10.1186/s12894-020-00737-9

来源: Springer

【 摘 要 】

BackgroundTubularized incised plate (TIP) urethroplasty is the most commonly performed procedure for hypospadias. Several flap procedures have been recommended to decrease the postoperative complication rate in TIP repair, but no single flap procedure is ideal. This study aimed to compare the outcomes of dartos fascia (DF) and tunica vaginalis fascia (TVF) as intermediate layers in TIP urethroplasty.MethodsWe searched PubMed, EMBASE, the Cochrane Library, Web of Science, clinicaltrials.gov, and other sources for comparative studies up to April 16, 2020. Studies were selected by the predesigned inclusion criteria. The primary outcomes were postoperative complications. The secondary outcomes were functional and cosmetic outcomes.ResultsThe pooled RR with 95% CI were calculated. We extracted the relevant information from the included studies. Only 6 comparative studies were included. No secondary outcomes were reported. The RR of the total complications rate for DF was 2.41 (95% CI 1.42–4.07, P = 0.0001) compared with TVF in TIP repair. For each postoperative complication, the RRs were 6.48 (2.20–19.12, P = 0.0007), 5.95 (1.13–31.30, P = 0.04), 0.62 (0.25–1.52, P = 0.29), and 0.75 (0.23–2.46, P = 0.64) for urethrocutaneous fistula, prepuce-related complications, meatal/urethral stenosis, and wound-related complications, respectively.ConclusionsThis meta-analysis reveals that compared to DF, TVF is a better option in TIP repair in terms of decreasing the incidence of the total postoperative complications, urethrocutaneous fistula, and prepuce-related complications. However there is limited evidence for functional and cosmetic outcomes. Overall, larger prospective studies and long-term follow-up data are required to further demonstrate the superiority of TVF over DF.Trial registration PROSPERO CRD42019148554.

【 授权许可】

CC BY