Kamal Baher Aly
Department of Urology, King Faisal University, Dammam, Saudi Arabia.
Urology. 2005 Nov;66(5):1095-8. doi: 10.1016/j.urology.2005.05.020.
To compare the single dartos flap with double dartos flap coverage. Two overlapping layers of dartos flap were fashioned and fixed in front of the neourethra after tubularized incised plate hypospadias repair to prevent urethrocutaneous fistula and glanular torsion.
A total of 96 boys with distal hypospadias were treated with tubularized incised plate urethroplasty. They were divided into two groups. Group 1 (54 patients) had a single dartos flap covering. Group 2 (42 patients) had double dartos flap coverings. The dissected dorsal dartos flap was bisected vertically to form two pedicled wings. Each wing was rotated laterally from either side of the glans to cover the neourethra ventrally in a double-layer fashion.
In group 1, 2 patients (3.7%) developed fistula, 49 (90.7%) had mild glanular torsion, and 5 (9.3%) had moderate glanular torsion. None of group 2 developed fistula or glanular torsion postoperatively.
Double dartos flaps covering of the neourethra is a simple procedure that was superior to single flap covering for the prevention of urethrocutaneous fistula after tubularized incised plate urethroplasty. Glanular torsion did not occur when double dartos flaps were used.
比较单肉膜瓣覆盖与双肉膜瓣覆盖的效果。在管状切开板尿道下裂修复术后，制作两层重叠的肉膜瓣并固定于新尿道前方，以预防尿道皮肤瘘和龟头扭转。
共有96例远端尿道下裂男孩接受了管状切开板尿道成形术。他们被分为两组。第1组（54例患者）采用单肉膜瓣覆盖。第2组（42例患者）采用双肉膜瓣覆盖。将游离的背侧肉膜瓣垂直平分形成两个带蒂翼。每个翼从龟头两侧向外侧旋转，以双层方式腹侧覆盖新尿道。
第1组中，2例患者（3.7%）发生瘘，49例（90.7%）有轻度龟头扭转，5例（9.3%）有中度龟头扭转。第2组术后均未发生瘘或龟头扭转。
双肉膜瓣覆盖新尿道是一种简单的手术方法，在预防管状切开板尿道成形术后尿道皮肤瘘方面优于单瓣覆盖。使用双肉膜瓣时未发生龟头扭转。
