Ghavami-Adel Maryam, Mollaeean Mansour, Hooman Nakysa
Department of Pediatric Surgery, Aliasghar Pediatric Hospital, Iran University of Medical Science.
Department of Surgery, Valiasr Hospital, Tehran University of Medical Sciences.
Iran J Pediatr. 2014 Aug;24(4):406-10. Epub 2014 Jul 4.
Hypospadias is a common birth defect of the penis. Besides the abnormal position of the urethral opening, there is usually a ventral preputial defect with preputial redundancy in dorsal shaft. There are many flap procedures for correcting this defect. Here, we present our experience of skin coverage procedure with better cosmetic results.
It is a prospective study on patients with mid-shaft to glandular hypospadias operated from June 2008 to December 2012. The operations were performed by one surgeon in two hospitals and the cosmetic results were evaluated by the surgeon, parents, and another pediatric surgeon by a satisfaction questionnaire. In this procedure, inner prepuce was incised curvilinearly, remaining 5 mm in medial and 8 mm in lateral aspects of the inner prepuce. For skin repair, dorsal flaps were approximated in midline along median raphe.
Sixty-three patients with mean age of 25.75±8.46 (7-93) months were followed up for 7.06±3.34 (2-15( months. There were 4 complications. The overall satisfaction with penile skin coverage was 93.7% for parents and 98.4% for surgeons. Patients' age and primary site of meatus had a significant correlation with cosmetic results (P<0.05), while urethroplasty techniques and post-operative complications were not significant.
Reapproximation of dorsal flaps in midline is a simple method and can be used in most cases of uncomplicated primary hypospadias. By this technique a more normal appearance can be achieved.
尿道下裂是一种常见的阴茎先天性缺陷。除尿道口位置异常外，通常还存在阴茎腹侧包皮缺损，阴茎背侧包皮冗余。有多种皮瓣手术可用于纠正这一缺陷。在此，我们介绍我们在皮肤覆盖手术方面的经验，其具有更好的美容效果。
这是一项对2008年6月至2012年12月接受中阴茎体至阴茎头型尿道下裂手术患者的前瞻性研究。手术由一名外科医生在两家医院进行，美容效果由该外科医生、患儿家长以及另一名儿科外科医生通过满意度问卷进行评估。在该手术中，沿曲线切开内包皮，在内包皮内侧保留5毫米，外侧保留8毫米。对于皮肤修复，将背侧皮瓣沿正中缝在中线处拉拢缝合。
63例平均年龄为25.75±8.46（7 - 93）个月的患者接受了7.06±3.34（2 - 15）个月的随访。出现了4例并发症。家长对阴茎皮肤覆盖的总体满意度为93.7%，外科医生为98.4%。患者年龄和尿道口的原发部位与美容效果有显著相关性（P<0.05），而尿道成形术技术和术后并发症则无显著相关性。
背侧皮瓣在中线处拉拢缝合是一种简单的方法，可用于大多数单纯性原发性尿道下裂病例。通过该技术可获得更正常的外观。
