Baka-Jakubiak M
Department of Paediatric Urology, Children's Memorial Health Institute, Warsaw, Poland.
BJU Int. 2000 Sep;86(4):513-8. doi: 10.1046/j.1464-410x.2000.00866.x.
To describe a one-stage combined bladder neck, urethral and penile reconstruction for achieving urinary continence and creating a penis with good cosmesis and function in boys with the exstrophy-epispadias complex.
Seventy-three boys underwent the combined procedure, including 36 after classic bladder exstrophy closure and 37 with epispadias. All were completely incontinent at the time of combined reconstruction. The bladder capacity just before surgery was 70-180 mL and was greater in those with epispadias. The boys were 2.5-11 years old, with those in the exstrophy group being slightly older.
Thirty-three boys (89%) with epispadias were completely continent during the day but 15 had episodes of nocturnal enuresis. Of boys with classic exstrophy, 27 (75%) were continent during the day but nine had occasional nocturnal enuresis. Eleven boys required intermittent catheterization, which they found easy to perform. In seven boys (10%) a urethrocutaneous fistula or urethral stricture developed.
Combined bladder neck, urethral and penile reconstruction can be carried out as a one-stage procedure in selected patients with adequate bladder capacity. Reconstruction of the whole length of the urethra facilitates intermittent catheterization.
描述一种一期联合膀胱颈、尿道和阴茎重建术，用于实现膀胱外翻 - 尿道上裂综合征患儿的尿失禁，并打造出外观和功能良好的阴茎。
73名男孩接受了联合手术，其中36名在经典膀胱外翻闭合术后接受手术，37名患有尿道上裂。所有患者在联合重建时均完全尿失禁。术前膀胱容量为70 - 180毫升，尿道上裂患者的膀胱容量更大。这些男孩年龄在2.5至11岁之间，膀胱外翻组的男孩年龄稍大。
33名（89%）尿道上裂男孩日间完全控尿，但15名有夜间遗尿情况。经典膀胱外翻男孩中，27名（75%）日间控尿，但9名偶尔有夜间遗尿。11名男孩需要间歇性导尿，他们觉得操作容易。7名男孩（10%）出现尿道皮肤瘘或尿道狭窄。
对于膀胱容量足够的特定患者，可将膀胱颈、尿道和阴茎联合重建作为一期手术进行。重建尿道全长便于间歇性导尿。
