Arshadi Hamid, Sabetkish Shabnam, Kajbafzadeh Abdol-Mohammad
Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Qarib's Street, Keshavarz Boulevard, Tehran, 1419433151, Iran.
Int Urol Nephrol. 2017 Dec;49(12):2099-2104. doi: 10.1007/s11255-017-1725-5. Epub 2017 Oct 16.
To report the feasibility of modified tubularized incised plate (TIP) urethroplasty technique for proximal hypospadias in 63 cases.
From January 2004 to March 2010, 63 patients underwent one-stage TIP urethroplasty (modified Snodgrass technique repair) using 2-3 of three covering layers (corpus spongiosum, dartos, and tunica vaginalis). The primary meatus was proximal penile, penoscrotal, scrotal, and perineal in 38, 13, 10, and 2 patients, respectively. All patients had chordee that was corrected with dorsal plication. Glanuloplasty was performed in all cases. Complications and cosmetic results were documented after 6-72 months of follow-up.
A total of 63 boys with proximal hypospadias underwent Snodgrass hypospadias repair at a mean age of 8.5 months (range 6-54). Mean operative time was 210 ± 35 min. Patients were followed up with 6-month intervals for up to 6 years postoperatively. After 6 years of follow-up, nine urethrocutaneous fistulae, four bleeding, four meatal stenoses, and one urethral stricture were reported. Cosmetic result was satisfactory according to parent's opinion and another surgeon. No residual chordee was observed in any cases (without artificial correction).
In conclusion, this preliminary report can be estimated as an alternative technique with acceptable complication and cosmetic results for proximal hypospadias correction.
报告改良管状切开板（TIP）尿道成形术治疗63例近端型尿道下裂的可行性。
2004年1月至2010年3月，63例患者接受了一期TIP尿道成形术（改良Snodgrass技术修复），使用三层覆盖组织（海绵体、肉膜和阴道白膜）中的2 - 3层。尿道口分别位于阴茎近端、阴茎阴囊、阴囊和会阴的患者有38例、13例、10例和2例。所有患者均有阴茎弯曲，通过背侧折叠进行矫正。所有病例均进行了龟头成形术。随访6 - 72个月后记录并发症和外观效果。
共有63例近端型尿道下裂男孩接受了Snodgrass尿道下裂修复术，平均年龄8.5个月（范围6 - 54个月）。平均手术时间为210±35分钟。术后患者每6个月随访一次，最长随访6年。随访6年后，报告有9例尿道皮肤瘘、4例出血、4例尿道口狭窄和1例尿道狭窄。根据家长和另一位外科医生的意见，外观效果令人满意。所有病例均未观察到残留阴茎弯曲（无需人工矫正）。
总之，这份初步报告可被视为一种治疗近端型尿道下裂的替代技术，其并发症和外观效果均可接受。
