Department of Paediatric Surgery, Division of Urology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
Acta Paediatr. 2012 Jul;101(7):755-60. doi: 10.1111/j.1651-2227.2012.02659.x. Epub 2012 Apr 4.
To evaluate the long-term effects on hypospadias repair with cultured autologous urothelial cells.
From 2000 to 2002, six patients with scrotal or perineal hypospadias and pronounced chordee were treated surgically with cultured autologous urothelial cell transplants. All patients were evaluated at 6-8 years postoperatively, that is, in the prepubertal period. The outcome was assessed with respect to cosmetic appearance, voiding function, urinary flow, artificial erection, urethroscopy and biopsies.
Median follow-up time was 7.25 years. Up to date, all patients present with a good cosmetic appearance. One of the boys prefers a sitting voiding position. Urinary flow curves are bell-shaped in all but one. All have straight erections, urethroscopy reveals an even, non-hair-bearing surface on the transplanted side and 2/6 present with urothelial cells in biopsies. Limitations of this follow-up study include a small group of patients and lack of controls. However, patients with severe hypospadias have high complication rates, and our results are equal or better than expected for the phenotype.
Tissue engineering for severe hypospadias repair can be performed in a safe manner. The method is feasible for treatment of a selected group of hypospadias, where pronounced chordee and shortage of preputial and penile skin complicates the creation of a neourethra.
评估培养自体尿路上皮细胞修复尿道下裂的长期效果。
2000 年至 2002 年，我们对 6 例阴囊型或会阴型尿道下裂伴明显阴茎下弯的患者采用培养的自体尿路上皮细胞移植进行手术治疗。所有患者均在术后 6-8 年，即青春期前进行评估，评估指标包括外观、排尿功能、尿流率、人工勃起、尿道镜检查和活检。
中位随访时间为 7.25 年。目前，所有患者的外观均良好。其中 1 例男孩喜欢坐式排尿。除 1 例外，尿流曲线均呈钟形。所有患者均有笔直的勃起，尿道镜检查显示移植侧表面均匀，无毛发，2/6 例活检中存在尿路上皮细胞。本随访研究的局限性包括患者数量少且缺乏对照组。然而，严重尿道下裂患者的并发症发生率较高，我们的结果与预期的表型相当或更好。
组织工程修复严重尿道下裂可以安全进行。该方法适用于治疗一组特定的尿道下裂患者，这些患者存在明显的阴茎下弯和包皮及阴茎皮肤短缺，使得新尿道的形成复杂化。
