Ying Jun, Ren Xiao-min, Xu Ming-xi, Wang Zhong, Yao De-hong, Yao Hai-jun
Department of Urology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200011, China.
Zhonghua Wai Ke Za Zhi. 2006 Jul 15;44(14):957-9.
To investigate the surgical technic of re-shape penis and scrotum, as well as construct urethra in severe hypospadias patients.
Twenty-two cases of perineal hypospadias with abnormal penis and scrotum were involved in operative repair. All the patients underwent two-stage of repair technic. The penis sponge were completely stretched out and uprighted in the first-stage. Foreskin and partial penis back skin was transferred into the ventral of penis and scrotum crack. At second-stage, urethroplasty was performed using bladder mucosa folded into half tube that sutured with urothra plate to reconstruct the urothra. The scrotum were re-shaped using foreskin and skinflap.
The operation's successful rate was 68% (15/22). There were 7 cases (32%) suffered from urethrocutaneous fistula and recovered after repair. Five cases (23%) occurred stricture of urethra and were treated by urethra dilatation. The appearance of penis and scrotum in 22 cases were satisfied.
The operative methods should be made according to the type of hypospadias and of scrotum. The technic were effective on severe hypospadias with abnormal scrotum, even for the patients who need more than 10 cm urethra construct. The appearance of penis and scrotum were satisfied after following up.
探讨重度尿道下裂患者阴茎及阴囊整形及尿道重建的手术技巧。
对22例会阴型尿道下裂合并阴茎及阴囊畸形患者行手术修复。所有患者均采用两期修复技术。一期将阴茎海绵体充分伸直并竖起,将包皮及部分阴茎背侧皮肤转移至阴茎腹侧及阴囊裂隙处。二期采用膀胱黏膜对折成半管状与尿道板缝合重建尿道,利用包皮及皮瓣对阴囊进行整形。
手术成功率为68%(15/22)。7例(32%)发生尿道皮肤瘘,经修复后愈合。5例(23%)发生尿道狭窄,经尿道扩张治疗。22例患者阴茎及阴囊外观满意。
手术方法应根据尿道下裂类型及阴囊情况制定。该技术对合并阴囊畸形的重度尿道下裂有效,即使对于需要构建超过10 cm尿道的患者也适用。随访后阴茎及阴囊外观满意。