Long Island Plastic Surgical Group, PC, Garden City, New York, NY, USA.
Urology. 2011 Dec;78(6):1424-9. doi: 10.1016/j.urology.2011.08.021. Epub 2011 Oct 19.
To review our experience with tissue expanders for resurfacing the penis in selected cases of complex hypospadias repairs.
We reviewed the medical records of 6 hypospadias male patients who underwent tissue expansion for phallic skin resurfacing. The patients ranged in age from 14-29 years of age at the time of placement of the tissue expander. All 6 patients had 5-8 failed surgeries and were "hypospadias cripples." In each case, the injection port was placed in the suprapubic area, whereas the tissue expander was placed under the skin on the dorsum of the penis. The tissue expanders were inflated slightly in the operating room and then subsequently at 2-week intervals over 12-16 weeks. At the point of maximum tissue expansion, the patients underwent reconstructive surgery and removal of the tissue expanders.
Successful tissue expansion occurred in all 6 patients. The patients then underwent penile skin flap reconstruction of their penises. Two patients developed minor complications (1 urethrocutaneous fistula, 1 meatal stenosis), which were successfully corrected. Long-term follow-up ranged from 1-22 years. Successful phallus resurfacing with penile skin was achieved in all 6 patients.
Patients who have undergone multiple attempted hypospadias repairs may lack a sufficient amount of healthy, unscarred penile skin for a successful outcome. These patients are therefore candidates for tissue expansion of the relatively normal skin usually found on the dorsum of the penis. In our experience, tissue expanders are a safe and effective method of acquiring genital skin for resurfacing in selected cases of hypospadias cripples and therefore should have a place in the surgical armamentarium of complex and redo-hypospadias repairs.
回顾我们在复杂尿道下裂修复中使用组织扩张器进行阴茎表面重建的经验。
我们回顾了 6 例接受组织扩张器进行阴茎皮肤覆盖的尿道下裂男性患者的病历。患者在放置组织扩张器时的年龄为 14-29 岁。所有 6 例患者均经历了 5-8 次失败的手术，属于“尿道下裂残疾者”。在每种情况下，注射端口均置于耻骨上方，而组织扩张器则置于阴茎背部的皮肤下。组织扩张器在手术室中略微充气，然后在 12-16 周的 2 周间隔内进行充气。在组织扩张的最大程度时，患者接受了重建手术并取出了组织扩张器。
所有 6 例患者均成功进行了组织扩张。然后，患者接受了阴茎皮肤瓣重建手术。2 例患者出现轻微并发症（1 例尿道皮瘘，1 例尿道口狭窄），均成功纠正。长期随访时间为 1-22 年。所有 6 例患者均成功实现了阴茎皮肤的阴茎表面重建。
多次尝试尿道下裂修复的患者可能缺乏足够数量的健康、无瘢痕的阴茎皮肤，无法获得成功的结果。因此，这些患者是阴茎背部通常发现的相对正常皮肤进行组织扩张的候选者。根据我们的经验，组织扩张器是一种安全有效的获取生殖器皮肤进行重建的方法，适用于选择的尿道下裂残疾患者，因此应该在复杂和再修复尿道下裂修复的手术武器库中占有一席之地。
