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应用人羊膜修复前尿道缺损:初步临床报告。

Use of human amniotic membrane repair of anterior urethral defect: First clinical report.

机构信息

Laser Application in Medical Science Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Clinical Research Development Unit, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Int J Urol. 2020 Jul;27(7):605-609. doi: 10.1111/iju.14257. Epub 2020 May 19.

Abstract

OBJECTIVE

To evaluate the use of human amniotic membrane allograft to prevent urethrocutaneous fistula after tubularized incised plate repair for redo-hypospadias and anterior urethral defects.

METHODS

This pilot study included 28 patients (mean age 25.3 ± 11 years) with a history of previous failed hypospadia repair, who underwent tubularized incised plate urethroplasty in one session by the same surgical team from April 2016 to April 2019. After the reconstruction of a neourethra and proper hemostasis, a human amniotic membrane allograft - Grafting Scaffold - was used to cover the suture lines.

RESULTS

The mean follow-up time was 13.3 ± 4.5 months. Two urethrocutaneous fistulas occurred within the first 2 weeks after the surgery, one of which was caused by the infection of the surgical site. No penile torsion, urethral diverticula, meatal stenosis or glans dehiscence was reported.

CONCLUSIONS

Amniotic membrane graft provides an applicable, low-cost, feasible, biodegradable and safe second cover in redo-hypospadias repairs by tubularized incised plate technique. Its use is technically easy; it has satisfactory cosmetic outcomes and might decrease urethrocutaneous fistula formation.

摘要

目的

评估人羊膜同种异体移植物在预防管状切开板修复后 redo-hypospadias 和前尿道缺损后尿道皮肤瘘中的应用。

方法

本初步研究纳入 28 例(平均年龄 25.3 ± 11 岁)既往失败的 hypospadia 修复史患者,均由同一手术团队于 2016 年 4 月至 2019 年 4 月一次完成管状切开板尿道成形术。重建新尿道并适当止血后,用人羊膜同种异体移植物(Grafting Scaffold)覆盖缝线。

结果

平均随访时间为 13.3 ± 4.5 个月。术后 2 周内发生 2 例尿道皮肤瘘,其中 1 例系手术部位感染所致。无阴茎扭转、尿道憩室、尿道口狭窄或龟头裂开。

结论

在采用管状切开板技术进行 redo-hypospadias 修复时,羊膜移植物提供了一种适用、低成本、可行、可生物降解和安全的二次覆盖。其使用技术简单,美容效果满意,可能降低尿道皮肤瘘的形成。

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