Kibar Yusuf, Roth Christopher, Frimberger Dominic, Kropp Bradley P
Department of Pediatric Urology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma 73104, USA.
Urology. 2009 Mar;73(3):510-4. doi: 10.1016/j.urology.2008.09.072. Epub 2008 Dec 18.
To present our long-term results with complete penile disassembly for epispadias repair.
We performed a retrospective review of our surgical records from 1996 to 2008. Group 1 included 12 patients who had undergone complete penile disassembly as a part of complete primary repair of bladder exstrophy, and group 2 included 9 patients with isolated epispadias.
The mean follow-up after epispadias repair was 58.2 and 58.6 months for groups 1 and 2, respectively. At the last follow-up visit, 83.3% of group 1 and 100% of group 2 were completely dry or had dry intervals >4 hours. Of the 21 children, 7 (33.3%) experienced minor complications, 4 in group 1 and 3 in group 2. No ischemic changes of the glans penis or corporal bodies were observed in either group. Erectile function was preserved in all patients.
Complete penile disassembly technique can achieve total or near complete urinary continence, decreasing the morbidity of multiple procedures and potentially allowing children to achieve continence at an earlier age. Our experience, with a mean follow-up of nearly 5 years and an overall complication rate of 33.3%, is comparable to that of other published series.
介绍我们采用完全阴茎解体术修复尿道上裂的长期结果。
我们对1996年至2008年的手术记录进行了回顾性研究。第1组包括12例作为膀胱外翻完全一期修复一部分而接受完全阴茎解体术的患者,第2组包括9例孤立性尿道上裂患者。
第1组和第2组尿道上裂修复后的平均随访时间分别为58.2个月和58.6个月。在最后一次随访时,第1组83.3%的患者和第2组100%的患者完全干燥或干燥间隔>4小时。21名儿童中,7名(33.3%)出现轻微并发症,第1组4例,第2组3例。两组均未观察到阴茎头或海绵体的缺血性改变。所有患者的勃起功能均得以保留。
完全阴茎解体术可实现完全或近乎完全的尿失禁,降低多次手术的发病率,并可能使儿童在更早的年龄实现尿失禁。我们的经验,平均随访近5年,总体并发症发生率为33.3%,与其他已发表系列的经验相当。