Soergel Trevor M, Cain Mark P, Kaefer Martin, Gitlin Jordan, Casale Anthony J, Davis Mary M, Rink Richard C
Department of of Urology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, USA.
J Urol. 2003 Oct;170(4 Pt 2):1577-8; 1578-9. doi: 10.1097/01.ju.0000083802.87337.af.
Small intestinal submucosa (SIS) has been described for corporal body grafting in cases of severe penile curvature. We reviewed our experience with a 2-stage repair using corporal body grafting with SIS for proximal hypospadias and severe chordee.
A retrospective chart review was performed on 12 patients with penoscrotal hypospadias and severe chordee. Corporal grafting was performed with a 4-layer SIS graft (STRATASIS, Cook Biotech, Spencer, Indiana). Patients were evaluated postoperatively with clinic visits after both stages of repair to assess results.
Corporal body grafting with SIS was performed in 12 patients between June and December 2001. Average patient age at the time of stage 1 repair was 9 months. Of the 12 patients 8 (66%) had no complications and 10 (83%) have a straight phallus following stage 2 repair. Complications occurred in 4 patients (33%), 2 of which were minor and did not require surgical correction. There were 2 major complications related to the SIS graft, 1 of which required excision of the graft and replacement with a tunica albuginea flap, and the other required 3 dorsal plications to correct residual chordee.
Our experience using the 4-layer SIS resulted in 2 major complications requiring surgical correction during stage 2 repair. This rate exceeds the complications reported with either dermal or tunica vaginalis grafts. Currently we have stopped using SIS for corporal grafting.
小肠黏膜下层（SIS）已被用于严重阴茎弯曲患者的阴茎体移植。我们回顾了采用SIS阴茎体移植两阶段修复近端尿道下裂和严重阴茎下弯的经验。
对12例阴茎阴囊型尿道下裂和严重阴茎下弯患者进行回顾性病历分析。采用4层SIS移植物（STRATASIS，库克生物技术公司，印第安纳州斯宾塞）进行阴茎体移植。在修复的两个阶段后，通过门诊随访对患者进行术后评估以评估结果。
2001年6月至12月期间，对12例患者进行了SIS阴茎体移植。1期修复时患者的平均年龄为9个月。12例患者中，8例（66%）无并发症，10例（83%）在2期修复后阴茎变直。4例患者（33%）出现并发症，其中2例为轻微并发症，无需手术矫正。有2例主要并发症与SIS移植物有关，其中1例需要切除移植物并用白膜瓣替代，另1例需要进行3次背侧折叠以矫正残余阴茎下弯。
我们使用4层SIS的经验导致在2期修复期间出现2例需要手术矫正的主要并发症。该发生率超过了真皮或鞘膜移植报道的并发症发生率。目前我们已停止使用SIS进行阴茎体移植。
