スエヨシ　リヨウ   末吉　亮    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Surgical management of hypospadias in cases with concomitant disorders of sex development.
掲載誌名	正式名：Pediatric surgery international 略　 称：Pediatr Surg Int ISSNコード：14379813/01790358
掲載区分	国外
巻・号・頁	35(5),pp.611-617
著者・共著者	Ochi Takanori, Ishiyama Asuka, Yazaki Yuta, Murakami Hiroshi, Takeda Masahiro, Seo Shogo, Sueyoshi Ryo, Lane Geoffrey J, Haruna Hidenori, Shimizu Toshiaki, Yamataka Atsuyuki
発行年月	2019/05
概要	INTRODUCTION:To review the surgical treatment of hypospadias (HP) associated with disorders of sex development (DSD).PATIENTS AND METHODS:HP cases were assessed for DSD by gross examination for atypical external genitalia, and assessment of hormone levels and karyotype. There were 58 HP cases with concomitant DSD treated between 1999 and 2017. DSD classification, type of HP, sex assignment, hormonal abnormality, surgical strategy, and post-urethroplasty complications (post-UPC) were reviewed.RESULTS:DSD were sex chromosome abnormalities (n = 4), 46,XY (n = 51), 46,XX (n = 1), and 47,XY + 21 (n = 2). HP was perineal: (n = 26), scrotal: (n = 16), penoscrotal: (n = 15), and midshaft: (n = 1); repair was primary (n = 6) or staged (n = 52). Mean age at final urethroplasty (UP) was 4.12 ± 0.21 years; all cases had soft tissue interposition at UP. At mean follow-up 5.16 ± 0.56 years after final UP, observed post-UPC (n = 8; 13.8%) were urethral stenosis (n = 3), urethral diverticulum (n = 2), urethrocutaneous fistula (n = 2), and curvature (n = 1). Mean onset of post-UPC was 1.24 ± 0.77 years (range 0.1-6.3). The second half of our cases (n = 29; treated 2015 ~) had significantly less post-UPC (0/29; 0%) than the first half (8/29; 27.6%) (p = 0.0075).CONCLUSIONS:Although UP for HP + DSD was formidably challenging, we achieved a significant decrease in post-UPC through a combination of surgical techniques and experience.
DOI	10.1007/s00383-019-04457-6
PMID	30762107