Radojicic Zoran I, Perovic Sava V, Djordjevic Miroslav L J, Vukadinovic Vojkan M, Djakovic Nebijsa
Paediatric Urology, University Children's Hospital, Belgrade, Serbia, Yugoslavia.
BJU Int. 2004 Jul;94(1):126-30. doi: 10.1111/j.1464-410X.2003.04913.x.
To describe a technique for repairing urethral diverticula which includes neourethral reconstruction and increasing the mechanical support of the neourethra.
Between February 1995 and May 2000, 267 patients with proximal hypospadias underwent a one-stage penile skin longitudinal flap urethroplasty. The overall postoperative complication rate was 20%; a diverticulum formed in 24 patients (9%) and in all it was repaired. Diverticulectomy was carried out by de-epithelialization of excess diverticular skin, so that two subcutaneous vascularized tissue wings could be created. After re-establishing distal urethral patency and neourethral closure, the de-epithelialized diverticular wings were folded and overlapped to form a mechanical support for the neourethral ventral wall; this procedure was termed 'pseudospongioplasty'.
There were no recurrences of diverticulum or any fistula formation. The only complication was urethral stenosis in two cases, which was successfully resolved by internal urethrotomy.
Re-establishing patency and providing mechanical support are essential when repairing a urethral diverticulum. Our technique with pseudospongiosal tissue reconstruction during the repair represents a good alternative or addition to other techniques.
描述一种修复尿道憩室的技术，该技术包括新尿道重建和增强新尿道的机械支撑。
1995年2月至2000年5月，267例近端尿道下裂患者接受了一期阴茎皮肤纵行皮瓣尿道成形术。术后总体并发症发生率为20%；24例患者（9%）形成了憩室，所有憩室均得到修复。憩室切除术通过去除多余憩室皮肤的上皮来进行，从而形成两个带血管的皮下组织瓣。在重建远端尿道通畅和新尿道闭合后，将去上皮化的憩室瓣折叠并重叠，为新尿道腹侧壁形成机械支撑；该操作被称为“假性海绵体成形术”。
憩室无复发，也未形成任何瘘管。仅2例出现尿道狭窄并发症，经尿道内切开术成功解决。
修复尿道憩室时，重建通畅并提供机械支撑至关重要。我们在修复过程中采用假性海绵体组织重建的技术是其他技术的良好替代方法或补充。
