Koshima I, Inagawa K, Okuyama N, Moriguchi T
Department of Plastic and Reconstructive Surgery, Kawasaki Medical School, Kurashiki City, Okayama, Japan.
Plast Reconstr Surg. 1999 Mar;103(3):964-9. doi: 10.1097/00006534-199903000-00030.
Despite the development of newer techniques with a free radial forearm tube flaps for phallus reconstruction, severe urethral strictures are still seen in such cases after irradiation or repeated infection because of the paucity of healthy, well-vascularized tissue. For urethral reconstruction in cases with poorly vascularized tissue as well as for total penile creation, a new technique involving a free vascularized appendix transfer combined with a radial forearm osteocutaneous flap was successfully used in two cases. The appendix provides a normal tube structure composed of a muscular tubular layer lined with mucosal epithelium. It has no hair and has rich vascularization. This results in little stricture at the junction with the original urethra, no occurrence of urethral stones, and possible postoperative enlargement of the diameter with changes in catheters. This method will allow a patient with severe fibrosis around the urethra to undergo one-stage phallus reconstruction with minimal complications.
尽管用于阴茎重建的游离桡骨前臂皮管皮瓣的新技术不断发展，但由于缺乏健康、血运良好的组织，此类病例在放疗或反复感染后仍会出现严重的尿道狭窄。对于组织血运差的病例进行尿道重建以及全阴茎再造，一种新的技术——游离带血管阑尾转移联合桡骨前臂骨皮瓣——成功应用于两例患者。阑尾提供了一个由内衬黏膜上皮的肌管层组成的正常管道结构。它没有毛发且血运丰富。这使得与原尿道连接处狭窄很少，不会发生尿道结石，并且术后随着导管更换可能出现管径增大。该方法将使尿道周围严重纤维化的患者能够进行一期阴茎重建，并发症最少。
