el-Kassaby Abdel-Wahab, Al-Kandari Ahmed M, Elzayat Tarek, Shokeir Ahmed A
Department of Urology, Ain Shams University, Cairo, Egypt.
Urology. 2008 Apr;71(4):611-5. doi: 10.1016/j.urology.2007.11.121. Epub 2008 Mar 4.
To present our experience with a modification of tubularized incised plate (TIP) urethroplasty for treatment of anterior penile hypospadias.
A total of 764 children with primary anterior penile hypospadias (462 subcoronal and 302 coronal) underwent hypospadias repair by using modified TIP urethroplasty. The technique involves, in addition to the standard TIP, the use of the dorsal prepuce which was divided in 2 flaps. The right flap was de-epithelialized on both the outer and inner sides and transferred as interposing layer between the neourethra and the coverings. The left flap was de-epithelialized on the inner side and transferred ventrally as skin coverage. The follow-up ranged between 3 and 52 months with a mean of 17 months.
Excellent functional and cosmetic results were achieved in 738 patients (96.6%). Urethral fistulae were encountered in 16 cases (2%) and were repaired successfully. Meatal stenosis was noted in 8 cases (1%) and successfully treated. Two patients had complete disruption of the wound (0.2%), which was corrected.
Excellent functional and cosmetic results can be achieved after repair of anterior penile hypospadias by using TIP urethroplasty with the modification of using double breasted de-epithelialized skin flap.
介绍我们采用改良管状切开包皮板（TIP）尿道成形术治疗阴茎前段尿道下裂的经验。
共有764例原发性阴茎前段尿道下裂患儿（462例冠状沟下型和302例冠状沟型）接受了改良TIP尿道成形术治疗尿道下裂。该技术除了标准的TIP外，还使用了分为两个皮瓣的背侧包皮。右侧皮瓣内外侧均去上皮，作为新尿道与覆盖组织之间的插入层转移。左侧皮瓣内侧去上皮，作为皮肤覆盖物腹侧转移。随访时间为3至52个月，平均17个月。
738例患者（96.6%）获得了优异的功能和外观效果。16例（2%）出现尿道瘘，均成功修复。8例（1%）出现尿道口狭窄，均成功治疗。2例患者伤口完全裂开（0.2%），已得到纠正。
采用改良的双瓣去上皮皮瓣的TIP尿道成形术修复阴茎前段尿道下裂后，可获得优异的功能和外观效果。
