Catti Massimo, Demède Delphine, Valmalle Anne-Frédérique, Mure Pierre-Yves, Hameury Frédéric, Mouriquand Pierre
Department of Pediatric Urology, Debrousse Hospital, Claude-Bernard University, Lyon, France.
Indian J Urol. 2008 Apr;24(2):233-40. doi: 10.4103/0970-1591.40621.
Many classifications of hypospadias have been published, mainly based on the position of the ectopic meatus, which is an insufficient criterion to define the severity of this malformation. What really marks the proximal landmark of this malformation is the level of division of the corpus spongiosum, which is always proximal to the ectopic meatus. In this article, we will focus on the most severe forms of hypospadias which include those with a proximal division of corpus spongiosum (below the midshaft), important chordee and a poor development of the ventral radius, reflecting a marked hypovirilization of the genital tubercle, and cripple hypospadias resulting from several previous failed surgical procedures. The principle of hypospadias surgery will be reviewed together with the outcome of the current surgical techniques. Furthermore, common complications will be outlined. There is no minor or major hypospadias and all forms require a solid experience of the surgeon, as minor looking hypospadias may turn out to be far more complex to repair than they appear once the ventral radius of the penis has been dissected.
已经发表了许多尿道下裂的分类方法，主要是基于异位尿道口的位置，而这作为定义这种畸形严重程度的标准并不充分。真正标志这种畸形近端界限的是海绵体的分裂水平，其总是位于异位尿道口的近端。在本文中，我们将聚焦于最严重的尿道下裂形式，包括那些海绵体近端分裂（在阴茎中段以下）、严重阴茎下弯以及腹侧阴茎弯曲发育不良的情况，这反映了生殖结节明显的雄激素不敏感，还有因先前多次手术失败导致的残废性尿道下裂。我们将回顾尿道下裂手术的原则以及当前手术技术的结果。此外，还将概述常见的并发症。不存在轻度或重度尿道下裂之分，所有形式都需要外科医生具备扎实的经验，因为一旦解剖阴茎的腹侧阴茎弯曲，看似轻度的尿道下裂可能比其外观显示的要复杂得多。
