Orkiszewski M, Leszniewski J
University of Medical Sciences, Bydgoszcz, Department of Paediatric Surgery, Children's Hospital, Torun, Poland.
Eur J Pediatr Surg. 2004 Feb;14(1):35-8. doi: 10.1055/s-2004-815778.
To determine whether longitudinal neourethra incision disturbs the healing and growth of the neourethra, and to see how it affects the urine flow after proximal hypospadias repairs.
Nine patients were examined, in whom longitudinal incision had been performed 9 - 15 years earlier, after previous penis lengthening operations. Calibration, urethrography, endoscopy, and urodynamics were carried out in all patients.
In all but 1 patient the external meatus had steadily been growing in width, and in 8 out of 9 it was within the normal size range. Urethroscopy showed single hairs growing into the lumen in 3 patients. No scarring was demonstrated in any patient. Saccular dilatation of the neourethra was found in 6 out of 9, urethral stricture was shown in only 1 patient. Peak flow rate was within 2 SD in 5 patients, and below 2 SD in 3. Average flow rate was below 2 SD in 6 patients and in all patients it was markedly low. In the patient with urethral stricture both peak flow rate and average flow rate were well below normal.
Although longitudinal neourethra incision allows for easy and safe closure, longitudinal incision may result in functional meatal stenosis with formation of a wide neourethra. This may be due to disproportional low resistance of the urethral wall, compared with external meatus, to urine flow.
确定纵向新尿道切开术是否会干扰新尿道的愈合和生长，并观察其对近端尿道下裂修复术后尿流的影响。
对9例患者进行了检查，这些患者在之前的阴茎延长手术后9至15年进行了纵向切开术。对所有患者进行了尿道扩张、尿道造影、内镜检查和尿动力学检查。
除1例患者外，所有患者的尿道口宽度均稳步增加，9例中有8例在正常尺寸范围内。尿道镜检查显示3例患者有毛发长入管腔。所有患者均未发现瘢痕形成。9例中有6例发现新尿道囊状扩张，仅1例患者出现尿道狭窄。5例患者的峰值流速在2个标准差范围内，3例低于2个标准差。6例患者的平均流速低于2个标准差，所有患者的平均流速均明显偏低。尿道狭窄患者的峰值流速和平均流速均远低于正常水平。
虽然纵向新尿道切开术便于安全闭合，但纵向切开可能导致功能性尿道口狭窄并形成宽大的新尿道。这可能是由于尿道壁与尿道口相比，对尿流的阻力不成比例地低。
