Ozgök Y, Ozgür Tan M, Kilciler M, Tahmaz L, Erduran D
Department of Urology, Gülhane Military Medical Academy, Ankara, Turkey.
Int J Urol. 2000 Oct;7(10):355-60. doi: 10.1046/j.1442-2042.2000.00210.x.
The ideal tissue for complex urethral reconstruction has yet to be determined, especially in patients with deficient preputium. The use of bladder mucosa as a free graft could be an alternative in these problem cases.
Bladder mucosa graft urethroplasty was performed on 14 patients with penoscrotal or scrotal hypospadias. The mean age of the patients was 18.7 (range 14-23) years. Ten cases were subjected to primary urethral reconstruction while four cases had previous hypospadias repair.
Complete urethral replacement by the bladder mucosa tube was performed in six patients. Meatal problems occurred in two (33.33%) patients and proximal fistula formed in one (16.67%) patient. A bladder mucosa graft was combined with preputial or tunica vaginalis grafts distally in eight cases, and one patient in the tunica vaginalis group developed fistula at the anastomosis of the bladder mucosa and tunica vaginalis grafts. The overall complication rate was 28.6%.
Our initial results showed that bladder mucosa grafts can be used successfully for urethral reconstruction especially when combined with preputial or tunica vaginalis grafts distally.
用于复杂尿道重建的理想组织尚未确定，尤其是在阴茎包皮缺损的患者中。在这些疑难病例中，使用膀胱黏膜作为游离移植物可能是一种选择。
对14例阴茎阴囊型或阴囊型尿道下裂患者进行膀胱黏膜移植尿道成形术。患者的平均年龄为18.7岁（范围14 - 23岁）。10例患者接受一期尿道重建，4例患者曾接受过尿道下裂修复术。
6例患者通过膀胱黏膜管完成了全尿道置换。2例（33.33%）患者出现尿道口问题，1例（16.67%）患者形成近端瘘。8例患者在远端将膀胱黏膜移植物与包皮或鞘膜移植物联合使用，鞘膜组1例患者在膀胱黏膜与鞘膜移植物吻合处出现瘘。总体并发症发生率为28.6%。
我们的初步结果表明，膀胱黏膜移植物可成功用于尿道重建，尤其是在远端与包皮或鞘膜移植物联合使用时。
