Acimi Smail, Abderrahmane Naima, Debbous Lamia, Acimi Mohammed Ali, Mansouri Juba
Department of visceral surgery, Children's hospital Canastel, Faculty of medicine, University of Oran, Oran, Algeria.
Department of visceral surgery, Children's hospital Canastel, Faculty of medicine, University of Oran, Oran, Algeria.
Urology. 2021 Jun;152:129-135. doi: 10.1016/j.urology.2020.11.058. Epub 2021 Jan 8.
To present the results of Koyanagi-Snow-Hayashi urethroplasty in severe hypospadias repair.
From June 2015 to December 2019, 43 patients with severe hypospadias associated with curvature underwent Koyanagi- Snow-Hayashi urethroplasty. All patients were treated for the first time and by a single surgeon. Thirty-five patients included in this study presented a form of disorders of sex development. The age of the patients at surgery varied from 12 to 120 months (mean age 21 months ± 6 months). The median follow-up was 28 months (range, 5-65 months).
Functional and esthetic results were satisfactory with a straight and excellent appearance of the penis, without any complications in only ten patients (23%). While 30 of 43 patients (70 %) required additional procedures. Postoperative complications encountered in our patients were dominated by fistulas which were found in 17 of 43 patients (39.5%). Among them, 3 fistulas appeared in the penile shaft between 11 and 28 days and disappeared spontaneously. While proximal fistulas have been required surgical repair. Diverticulum seemed to be a significant complication of this technique, it was found in 4 of 43 (9%). This study also revealed the presence of a peculiar complication for this procedure, urethral meatus in the shape of fish lips.
The use of Koyanagi-Snow-Hayashi urethroplasty in severe hypospadias repair gives a complete penile straightening in all cases. However, Despite the modifications added by Snow and Hayashi to Koyanagi urethroplasty to improve the vascular supply of the flap, the rate of complications encountered with this technique remains high.
介绍小柳-斯诺-林氏尿道成形术在重度尿道下裂修复中的效果。
2015年6月至2019年12月，43例伴有阴茎弯曲的重度尿道下裂患者接受了小柳-斯诺-林氏尿道成形术。所有患者均为首次接受治疗且由同一位外科医生操作。本研究纳入的35例患者存在某种性发育障碍。患者手术时的年龄在12至120个月之间（平均年龄21个月±6个月）。中位随访时间为28个月（范围5 - 65个月）。
功能和美学效果令人满意，阴茎外观笔直且良好，仅10例患者（23%）未出现任何并发症。而43例患者中有30例（70%）需要额外的手术。我们的患者术后并发症以瘘管为主，43例患者中有17例（39.5%）出现瘘管。其中，3例阴茎体部瘘管在11至28天出现并自行消失。而近端瘘管则需要手术修复。憩室似乎是该技术的一个重要并发症，43例中有4例（9%）出现。本研究还揭示了该手术存在一种特殊并发症，即鱼唇状尿道口。
小柳-斯诺-林氏尿道成形术用于重度尿道下裂修复在所有病例中均能实现阴茎完全伸直。然而，尽管斯诺和林氏对小柳尿道成形术进行了改进以改善皮瓣的血供，但该技术的并发症发生率仍然很高。
