Hypospadias Clinic, Department of Pediatric Surgery, Emma and Sana Offenbach Hospitals, Germany.
J Pediatr Surg. 2014 Jan;49(1):218-23. doi: 10.1016/j.jpedsurg.2013.09.067. Epub 2013 Nov 9.
The purpose of this study was to present the "bilateral based skin flap (BILAB) technique" for patients with perineal hypospadias associated with severe deep chordee and report the follow up.
The short urethral plate is incised, the hypoplastic corpus spongiosum excised, the glans split in the midline, and a healthy urethral plate is reconstructed from the lateral penile skin and foreskin to the tip of the glans.
Between January 2005 and December 2011, the BILAB technique was performed in 68 patients with perineal hypospadias associated with severe chordee as a one or two stage repair. The records of 63 patients who maintained regular follow up were reviewed. The new urethra was reconstructed from the new urethral plate during the same setting in 26 patients. The remaining 37 patients had the urethroplasty performed 3-6 months later as a two stage repair. Patient age ranged from 8 months and 2 years (mean 10 months). Follow-up period ranged from 18 months to 8 years (mean 43 months).
Satisfactory results were obtained in 54 patients (85%). Two children developed diverticula, two patients developed glans dehiscence, one child developed fistula, and one child had complete wound dehiscence, and urethroplasty was successfully reconstructed 6 months later. Three patients developed scar contraction 6-12 months after surgery. This was corrected by excision of the scarred intermediate layer.
The BILAB technique is a reliable technique for patients with perineal hypospadias. It produces slit like meatus at the tip of the glans. The surgeon may decide intra-operatively whether to complete the urethroplasty in one or two stages. Long term follow up until puberty is being carried out.
本研究旨在介绍一种用于会阴型尿道下裂伴严重深部弯曲的患者的“双侧皮瓣（BILAB）技术”，并报告其随访结果。
切开短的尿道板，切除发育不良的海绵体组织，将龟头在中线劈开，从阴茎侧皮肤和包皮到龟头尖端重建健康的尿道板。
2005 年 1 月至 2011 年 12 月，我们对 68 例会阴型尿道下裂伴严重弯曲的患者采用 BILAB 技术进行一期或二期修复。回顾了 63 例有规律随访记录的患者。26 例患者在同一部位从新的尿道板重建新尿道，其余 37 例患者在 3-6 个月后进行二期修复。患者年龄 8 个月至 2 岁（平均 10 个月）。随访时间 18 个月至 8 年（平均 43 个月）。
54 例（85%）患者获得满意结果。2 例患儿出现憩室，2 例患儿出现龟头裂开，1 例患儿出现瘘管，1 例患儿出现完全伤口裂开，6 个月后成功进行了尿道成形术。3 例患儿术后 6-12 个月出现瘢痕收缩，通过切除瘢痕中层进行了矫正。
BILAB 技术是一种治疗会阴型尿道下裂的可靠技术。它在龟头尖端产生裂隙状尿道口。术者可根据术中情况决定是否一期或二期完成尿道成形术。正在对患儿进行长期随访至青春期。
