尿道下裂修復術における異なる術式：多施設共同前向きコホート研究による長期機能的・整容的転帰

Hypospadias repair aims to achieve both functional and cosmetic restoration of the penis. Long-term outcomes vary depending on the surgical technique employed.

A prospective, multicenter cohort study was conducted involving 180 patients aged 6 months to 7 years undergoing primary hypospadias repair. Patients were followed up for a minimum of 2 years to assess urinary stream, cosmetic appearance, and complication rates.

Tubularized incised plate (TIP) repair showed superior cosmetic outcomes with a 92% parental satisfaction rate. Onlay flap had a lower complication rate (6.7%), while the Bracka repair was reserved for proximal hypospadias and had acceptable results but higher complication rates (15%). Functional outcomes were comparable in all groups.

Surgical technique selection should be tailored based on hypospadias severity. TIP repair offers excellent cosmetic results in distal cases, while Onlay flap and Bracka remain reliable for more complex cases.