Harper Luke, Michel Jean-Luc, Sauvat Frederique
Department of Pediatric Surgery, CHU F Guyon, Bellepierre, Saint-Denis de La Réunion, Réunion Island, France.
BJU Int. 2017 Mar;119(3):470-473. doi: 10.1111/bju.13604. Epub 2016 Aug 17.
To evaluate clinical use of a tunica vaginalis flap as the dorsal component of a two-stage urethroplasty in boys with cripple hypospadias.
We performed the first stage of a Bracka two-stage urethroplasty, using a tunica vaginalis flap as the dorsal component in six boys with cripple hypospadias. We analysed their clinical characteristics and the results of this technique.
The mean (range) age of the boys was 57 (34-120) months. The mean (range) number of previous procedures the boys had undergone was 4 (3-5). At the 6-month follow-up, all the boys presented significant fibrosis of the dorsal graft rendering it unusable for tubularisation.
Exposure to the external environment seems to induce retraction and fibrosis of the tunica vaginalis. We believe one should be very cautious about using tunica vaginalis as the dorsal component of a two-stage urethroplasty, as significant fibrosis might well render the flap unusable.
评估在重度尿道下裂男孩中，使用睾丸鞘膜瓣作为两阶段尿道成形术背侧成分的临床应用。
我们对6例重度尿道下裂男孩实施了Bracka两阶段尿道成形术的第一阶段，使用睾丸鞘膜瓣作为背侧成分。我们分析了他们的临床特征以及该技术的结果。
男孩的平均（范围）年龄为57（34 - 120）个月。男孩之前接受手术的平均（范围）次数为4（3 - 5）次。在6个月的随访中，所有男孩的背侧移植物均出现明显纤维化，无法用于管状化。
暴露于外部环境似乎会导致睾丸鞘膜退缩和纤维化。我们认为，在两阶段尿道成形术中使用睾丸鞘膜作为背侧成分时应非常谨慎，因为严重的纤维化很可能使皮瓣无法使用。
