Acimi Smail, Acimi Mohammed Ali
From the Visceral Surgery, Children's Hospital Canastel, Faculty of medicine, University Of Oran, Oran Algeria.
Ann Plast Surg. 2017 Jul;79(1):68-72. doi: 10.1097/SAP.0000000000001055.
To know the limits of the preservation of the urethral plate in the correction of the curvature associated with proximal hypospadias.
From January 2002 to January 2015, we treated 224 patients of proximal hypospadias. In 182 cases, we used of the lateral pictures taken during the successive saline erection tests to measure the correction obtained after each stage.
The analysis of the lateral pictures taken at the successive saline erection tests clearly demonstrated that release of the skin and dartos fascia provides an important correction of the chordee. This correction is complete of all curvature lower than 45 degrees and in 3 fourths of cases for curvatures between 45 and 90 degrees. However, for angles 90 degree and more, the release of the skin and dartos fascia was insufficient in more than 73.7% of cases. And the mobilization of the urethral plate with resection of the underlying fibrous tissue realized gives a very low correction of the chordee (0-20 degrees).
The essential factor responsible of curvature associated with proximal hypopsadias is the fibrosis tissue present on the ventral side of the penis. However, in the severe forms, a short urethral plate must be transected to obtain a complete correction of the chordee.
了解在矫正近端尿道下裂相关弯曲时保留尿道板的限度。
2002年1月至2015年1月，我们治疗了224例近端尿道下裂患者。在182例患者中，我们利用连续盐水勃起试验期间拍摄的侧位照片来测量每个阶段后获得的矫正情况。
对连续盐水勃起试验时拍摄的侧位照片进行分析清楚地表明，皮肤和肉膜筋膜的松解对阴茎弯曲有重要的矫正作用。对于所有小于45度的弯曲，这种矫正都是完全的；对于45至90度之间的弯曲，四分之三的病例矫正也是完全的。然而，对于90度及以上的角度，在超过73.7%的病例中，皮肤和肉膜筋膜的松解是不够的。并且通过切除其下方的纤维组织来游离尿道板，对阴茎弯曲的矫正非常小（0 - 20度）。
近端尿道下裂相关弯曲的主要原因是阴茎腹侧存在的纤维化组织。然而，在严重的病例中，必须横断短的尿道板以获得阴茎弯曲的完全矫正。
