Baccala Angelo A, Ross Jonathan, Detore Nicholas, Kay Robert
Department of Pediatric Urology, Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Urology. 2005 Dec;66(6):1305-6. doi: 10.1016/j.urology.2005.07.011.
To report the outcomes in a large series using a modified tubularized incised plate (TIP) urethroplasty (Snodgrass) technique with a local de-epithelialized skin flap to cover the urethroplasty. The use of the TIP urethroplasty (Snodgrass) technique has gained wide acceptance among pediatric urologists for the correction of hypospadias repair because of its good cosmesis, low complication rate, and reliability in creating a vertically oriented meatus.
A total of 101 boys, aged 6 months to 3 years, with distal (n = 85), mid-shaft (n = 8), or proximal (n = 8) hypospadias underwent one-stage repair using a modified TIP repair with a local de-epithelialized skin flap to cover the urethroplasty. Charts were reviewed for each patient to determine the complications, reoperations, cosmesis, and functional results after surgery.
With at least 6 months of follow-up, all patients had achieved excellent functional and cosmetic results, with the meatus at the tip of the penis on follow-up. Three repairs for meatal stenosis and two for fistula were needed.
The modified TIP procedure is a safe and reliable technique. It provides excellent cosmesis with a low reoperation rate.
报告一系列采用改良管状切开板（TIP）尿道成形术（斯诺德格拉斯术式）并使用局部去上皮化皮瓣覆盖尿道成形术的治疗结果。TIP尿道成形术（斯诺德格拉斯术式）因其良好的美容效果、低并发症发生率以及在创建垂直尿道口方面的可靠性，已在小儿泌尿外科医生中得到广泛认可，用于尿道下裂修复。
共有101名年龄在6个月至3岁之间的男孩接受了一期修复手术，其中远端尿道下裂（n = 85）、阴茎体中段尿道下裂（n = 8）或近端尿道下裂（n = 8），采用改良TIP修复术并使用局部去上皮化皮瓣覆盖尿道成形术。对每位患者的病历进行回顾，以确定术后的并发症、再次手术情况、美容效果和功能结果。
至少随访6个月后，所有患者在随访时尿道口均位于阴茎头顶端，功能和美容效果均极佳。需要进行3次尿道外口狭窄修复和2次瘘管修复。
改良TIP手术是一种安全可靠的技术。它具有良好的美容效果，再次手术率低。
