Bertozzi M, Yıldız A, Kamal B, Mustafa M, Prestipino M, Yiğiter M, Al-Darawany H, Oral A, Nardi N, Appignani A
S. C. di Clinica Chirurgica Pediatrica, Ospedale S. Maria della Misericordia, Università degli Studi di Perugia, 06100 S. Andrea delle Fratte, Perugia, Italy.
Pediatr Surg Int. 2011 Dec;27(12):1331-6. doi: 10.1007/s00383-011-2978-1. Epub 2011 Sep 21.
We report a multicenter experience using double dartos flap to protect the neourethra in TIP urethroplasty for distal and midpenile hypospadias.
A total of 394 patients underwent tubularized incised plate urethroplasty for primary distal and midpenile hypospadias using double dartos flap protection by ten pediatric surgeons and urologists at five different institutions.
Tubularized incised plate urethroplasty protected by a double dartos flap was simple to perform and flaps were easy to obtain. Complications occurred in 23 patients (5.83%): fistulas 1.01% (4 cases), stenosis 0.25% (1 case), mild stenosis 2.53% (10 cases), dehiscence of ventral cutis 0.50% (2 cases) and penile torsion 1.26% (5 cases). All fistulae had a spontaneous resolution.
Double dartos flap to protect tubularized incised plate urethroplasty is safe with a low complication rate. The neourethra is covered entirely with a double layer of vascularized tissue and the double coverage appears a good choice for preventing urethrocutaneous fistula formation.
我们报告一项多中心经验，即在阴茎头成形术治疗远端及中段阴茎型尿道下裂时使用双层肉膜瓣保护新尿道。
五家不同机构的十位儿科外科医生和泌尿科医生对总共394例原发性远端及中段阴茎型尿道下裂患者采用双层肉膜瓣保护进行管状切开板尿道成形术。
双层肉膜瓣保护的管状切开板尿道成形术操作简单，瓣片易于获取。23例患者（5.83%）出现并发症：瘘管形成1.01%（4例），狭窄0.25%（1例），轻度狭窄2.53%（10例），腹侧皮肤裂开0.50%（2例），阴茎扭转1.26%（5例）。所有瘘管均自行愈合。
双层肉膜瓣保护管状切开板尿道成形术安全，并发症发生率低。新尿道完全被双层血管化组织覆盖，这种双重覆盖似乎是预防尿道皮肤瘘形成的良好选择。
