Nagai Atsushi, Nasu Yasutomo, Watanabe Masami, Kusumi Norihiro, Tsuboi Hiromu, Kumon Hiromi
Department of Urology, Okayama University Graduate School of Medicine and Dentistry, Japan.
Acta Med Okayama. 2005 Apr;59(2):45-8. doi: 10.18926/AMO/31964.
We investigated the usefulness of one-stage urethroplasty by the parameatal foreskin flap method (OUPF procedure), which is useful for repairing all types of hypospadias. Between June 1992 and March 2001, the OUPF procedure was performed on 18 patients with hypospadias: 10 patients with distal and 8 with proximal hypospadias. The follow-up periods ranged from 33-75 months, with an average of 52 months. The duration of surgery, the catheter indwelling period, and the postoperative complications of each patient were analyzed. The median age of the patients at the time of surgery was 3 years and 8 months. The length of surgery for OUPF II ranged from 150-230 min (average 186 min), and from 190-365 min (average 267 min) for OUPF IV. Postoperative complications were confirmed in 3 of the 18 patients (16.6%). Two patients had fistulas, and one had a meatal regression. The fistulas were successfully closed by the simple multilayered closure method. After adopting DuoDerm dressings instead of elastic bandages for protection of the wound, no fistulization occurred. DuoDerm dressings are useful in the healing of wounds without complications. To date, the longest follow-up period has been 75 months, and during that time there have been no late complications such as urethral stenosis or penile curvature. OUPF is a useful method in the treatment of hypospadias with a low incidence of early and late complications.
我们研究了采用尿道口包皮瓣法一期尿道成形术(OUPF手术)的有效性,该方法对各类尿道下裂的修复均有效。1992年6月至2001年3月期间,对18例尿道下裂患者实施了OUPF手术:其中10例为远端尿道下裂,8例为近端尿道下裂。随访时间为33 - 75个月,平均52个月。分析了每位患者的手术时长、导尿管留置时间及术后并发症。患者手术时的中位年龄为3岁8个月。OUPF II的手术时长为150 - 230分钟(平均186分钟),OUPF IV的手术时长为190 - 365分钟(平均267分钟)。18例患者中有3例(16.6%)出现术后并发症。2例患者出现瘘管,1例出现尿道口退缩。瘘管通过简单的多层缝合方法成功闭合。采用多爱肤敷料代替弹性绷带保护伤口后,未再发生瘘管形成。多爱肤敷料对无并发症伤口的愈合有用。迄今为止,最长随访期为75个月,在此期间未出现尿道狭窄或阴茎弯曲等晚期并发症。OUPF是治疗尿道下裂的一种有效方法,早期和晚期并发症发生率低。