Cordon Billy H, Armenakas Noel A
Department of Urology, Lenox Hill Hospital/North Shore-LIJ, New York, NY 10065, USA.
Transl Androl Urol. 2015 Feb;4(1):35-40. doi: 10.3978/j.issn.2223-4683.2015.01.01.
Strictures involving the penile urethra generally require tissue transfer techniques. Ventral graft placement usually is avoided in the penile urethra because of the relative paucity of viable corpus spongiosal tissue necessary for vascularization and support. Instead, grafts are commonly placed dorsally using either an onlay or inlay technique. However, the successful use of ventrally placed grafts in the penile urethra supported by a pseudospongioplasty has recently been reported. The incorporation of a pseudospongioplasty provides a well-vascularized milieu for successful graft take in the penile urethra. This technique incorporates periurethral flaps of tunica dartos and Buck's fascia for graft coverage. Pseudospongioplasty in the penile urethra has been shown to have a similar efficacy to standard spongioplasty in the bulbar urethra. Additionally, pseudospongioplasty outcomes are comparable to other graft augmentation techniques performed in the penile urethra. In penile strictures, where there is a paucity of spongiosal tissue, pseudospongioplasty for coverage of a ventral graft is a reliable option.
累及阴茎尿道的狭窄通常需要组织移植技术。由于阴茎尿道血管化和支撑所需的海绵体组织相对较少，一般避免在阴茎尿道腹侧放置移植物。相反，移植物通常采用覆盖法或嵌入法置于背侧。然而，最近有报道称，在假海绵体成形术的支持下，在阴茎尿道腹侧成功放置移植物。假海绵体成形术为阴茎尿道移植物的成功植入提供了血管丰富的环境。该技术采用肉膜和巴克筋膜的尿道周围皮瓣覆盖移植物。阴茎尿道假海绵体成形术已被证明与球部尿道标准海绵体成形术具有相似的疗效。此外，假海绵体成形术的结果与在阴茎尿道进行的其他移植物增大技术相当。在海绵体组织较少的阴茎狭窄中，用假海绵体成形术覆盖腹侧移植物是一种可靠的选择。
