IMPROVEMENT OF METHODS OF TREATMENT OF GIPOSPADIA IN CHILDREN. STUDY PROTOCOL
Introduction. Hypospodias refers to widespread anomalies of the genital organs. Treatment of hypospadias in children is performed only surgically. The variety of applied methods of treatment is caused by a large number of complications and the search for the optimal method of surgery for the correction of hypospadias. The aim: to improve the results of treatment of anterior and middle hypospadias in children by introducing a modified urethroplasty method with a flap of the foreskin on the “feeding leg” and reducing postoperative complications. Objectives: 1. Retrospective analysis of the results of one-two-stage surgical correction of hypostadines, previously used in Astana, “The National Science Center for Maternity and Childhood”, “City Hospital #2 in Ust’-Kamenogorsk “The center for mother and child” in the period of 2010 and 2015; The study of the world experience of the treatment of hypospadin in foreign countries on the basis of the results of deep-seated 7-8 years research in search databases as: PubMed/Medline, Web of Science, EBSCO, Cochrane Library. 2. Clinical examination of patients: the presence of complaints, assessment of local status-form and appearance of the penis, the location of the meatus, the absence of the urethral-cutaneous fistula, as well as stenosis and diverticulum and neurethra; 3. Evaluation of the effectiveness of the applied modified method of treatment by performing urethrography with a water-soluble iodine-containing contrast agent and uroflowmetry. Materials and methods. Design of the study: a nonrandomized clinical, controlled trial. Studied nosologies: hypospadias with the following forms from the distal, middle-stem, lower third of the trunk of the gently sloping member; complications of urethroplasty: urethral-dermal fistula, dystopia meatus. Expected result and conclusions. The use of the initiated method of surgical treatment in the Medical Center Of the Semey State Medical University in 2014 (invention №90249 of 13.10.2014) children with distal forms of hypospadias showed the absolute advantage of the modified method in comparison with previously used methods correction of hypospadias in terms of complications. Application of the modified method (invention №102547 of 29.08.2016) of urethral plasty with a flap of the prepuce on the feeding leg in patients with mid-stem and proximal-stem forms of hypospadines will improve the results of surgical treatment,reduce the number of postoperative complications, the multiplicity of surgical interventions, and ensure earl adaptation of children to society