Joseph D B, Pérez L M
Department of Surgery, University of Alabama at Birmingham Children's Hospital, USA.
J Urol. 1999 Sep;162(3 Pt 2):1146-7. doi: 10.1016/S0022-5347(01)68103-5.
We review our experience with tunica vaginalis onlay urethroplasty for urethral repair after multiple previous hypospadias repairs.
From January 1992 through December 1997 we repaired the urethra in 10 boys and 1 man using a tunica vaginalis onlay flap. The tunica vaginalis was placed as a patch on the urethra that was proximal to the glans or brought out to the urethral meatus.
No intraoperative complications or difficulties were associated with harvesting the tunica vaginalis. Of the 4 children and 1 adult in whom the onlay flap was brought out to the urethral meatus meatal stenosis developed in 3 (60%), while 2 void without problems. In 6 children the onlay flap was placed proximal to the glans and in 1 who was lost to followup 2 discontinuous patches were placed. In 3 of the 5 remaining boys (60%) stricture developed, while 2 void without problems.
Tunica vaginalis onlay urethroplasty results in a substantial complication rate. We did not confirm any advantage of its use.
我们回顾了使用睾丸鞘膜覆盖尿道成形术修复多次既往尿道下裂修复术后尿道的经验。
1992年1月至1997年12月，我们使用睾丸鞘膜覆盖皮瓣为10名男孩和1名男性修复尿道。将睾丸鞘膜作为补片置于龟头近端的尿道上，或引出至尿道口。
获取睾丸鞘膜未出现术中并发症或困难。在4名儿童和1名成人中，将覆盖皮瓣引出至尿道口，其中3例（60%）出现尿道口狭窄，2例排尿无问题。6名儿童的覆盖皮瓣置于龟头近端，1名失访患者放置了2个间断补片。在其余5名男孩中的3例（60%）出现狭窄，2例排尿无问题。
睾丸鞘膜覆盖尿道成形术导致较高的并发症发生率。我们未证实其使用有任何优势。
