Surer I, Baker L A, Jeffs R D, Gearhart J P
Division of Pediatric Urology, Department of Urology, Brady Urological Institute, The Johns Hopkins Hospital and School of Medicine, Baltimore, Maryland, USA.
J Urol. 2000 Sep;164(3 Pt 2):1040-2; discussion 1042-3. doi: 10.1097/00005392-200009020-00029.
We evaluate our experience with the modified Cantwell-Ransley epispadias repair technique to determine the complications and long-term results.
The modified Cantwell-Ransley epispadias repair was performed during the last 10 years in 93 males of whom 79 had classic bladder exstrophy and 14 had complete epispadias. Primary repair was performed in 65 boys with classic bladder exstrophy and 12 with epispadias, and secondary repair was done after prior failed reconstruction in 14 boys with classic exstrophy and 2 with complete epispadias.
At mean followup of 68 months 87 patients had a horizontal or downward angled penis while standing. The incidence of urethrocutaneous fistulas was 23% in the immediate postoperative period and 19% at 3 months. A urethral stricture at the proximal anastomotic area developed in 7 patients and 5 (4 with exstrophy and 1 with epispadias) had minor skin separations of the dorsal penile skin closure. Catheterization or cystoscopy in 77 cases revealed an easily negotiable neourethral channel.
The modified Cantwell-Ransley epispadias repair produces an excellent functional and cosmetic result.
我们评估改良坎特韦尔-兰斯利尿道上裂修复技术的经验，以确定并发症和长期结果。
在过去10年中，对93例男性患者实施了改良坎特韦尔-兰斯利尿道上裂修复术，其中79例患有典型膀胱外翻，14例患有完全性尿道上裂。65例患有典型膀胱外翻的男孩和12例患有尿道上裂的男孩进行了一期修复，14例患有典型膀胱外翻的男孩和2例患有完全性尿道上裂的男孩在先前重建失败后进行了二期修复。
平均随访68个月时，87例患者站立时阴茎呈水平或向下弯曲。术后即刻尿道皮肤瘘的发生率为23%，3个月时为19%。7例患者在近端吻合区出现尿道狭窄，5例（4例膀胱外翻和1例尿道上裂）阴茎背侧皮肤闭合处有轻微皮肤分离。77例患者的导尿或膀胱镜检查显示新尿道通道易于通过。
改良坎特韦尔-兰斯利尿道上裂修复术产生了优异的功能和美容效果。
