Manisa Celal Bayar University, Department of Pediatric Surgery, Division of Pediatric Urology, Manisa-Turkey.
Manisa Celal Bayar University, Department of Pediatric Surgery, Manisa, Turkey.
Urology. 2021 Feb;148:243-249. doi: 10.1016/j.urology.2020.10.007. Epub 2020 Oct 17.
To report current results of a new surgical technique, tubularized reconstructed plate urethroplasty (TRPU) in distal hypospadias repair which allows the tubularization of urethral plate without incision or grafting.
This study is a prospective single surgeon series. Between January 2019 and March 2020, total of 158 patients underwent hypospadias repair, and 29 selected patients had TRPU procedure. Demographic data, duration of follow-up, complications were recorded. A vertical incision is made starting from halfway up the glans. This incision creates a diamond like defect which enables wedge removal of a segment of spongiosum tissue from the base of urethral plate extending to the hypospadiac meatus. Vertical incision is closed horizontally. The urethral plate is stretched and loosened from the base and re-secured into its bed using quilting stitches. Reconstructed urethral plate ensures the required width to allow the formation of neourethra of adequate circumference, followed by a formal glansplasty.
Preoperative glans width was 13.4 ± 0.9 mm, urethral plate width was 6.1 ± 0.9 mm. Mean postoperative follow-up period was 13.6 months. All patients had successful functional outcome and cosmetically satisfying appearance. None of the patients required meatal calibration. The total complication rate was 3.4%.
Native urethral plate itself is used as a natural flap to increase the surface area of the urethral plate in this new perspective of urethroplasty method. We believe that TRPU procedure provides an alternative approach for the formation of neourethra and it is a successful and relatively simple procedure with low complication rates, good cosmetic results and promising successful functional short-term outcome.
报告一种新的手术技术——管状重建板尿道成形术（TRPU）在远端尿道下裂修复中的最新结果，该技术可在不切开或移植的情况下使尿道板形成管状。
本研究为前瞻性单外科医生系列研究。2019 年 1 月至 2020 年 3 月，共有 158 例患者接受了尿道下裂修复，其中 29 例患者选择了 TRPU 手术。记录患者的人口统计学数据、随访时间和并发症情况。从龟头的一半处开始做一个垂直切口。这个切口形成一个菱形的缺损，使海绵体组织的一个楔形从尿道板的底部到尿道下裂的尿道口被切除。垂直切口水平闭合。将尿道板从底部拉伸和松动，并使用缝合线重新固定在其床内。重建的尿道板确保了所需的宽度，以允许形成足够周长的新尿道，然后进行正式的龟头成形术。
术前龟头宽度为 13.4±0.9mm，尿道板宽度为 6.1±0.9mm。平均术后随访时间为 13.6 个月。所有患者均获得了成功的功能结果和满意的美容外观。无需行尿道口校准。总并发症发生率为 3.4%。
在这种新的尿道成形术方法中，尿道板本身被用作天然皮瓣，以增加尿道板的表面积。我们认为，TRPU 手术为新尿道的形成提供了一种替代方法，该手术是一种成功且相对简单的手术，具有较低的并发症发生率、良好的美容效果和有前途的短期成功的功能结果。
