Permana Wien, Djojodimedjo Tarmono, Renaldo Johan
Department of Urology, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Department of Urology, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Int J Surg Case Rep. 2021 Mar;80:105698. doi: 10.1016/j.ijscr.2021.105698. Epub 2021 Feb 26.
Megameatus intact Prepuce (MIP) is a rare variant of hypospadias characterized by a wide meatus with a normally conformed prepuce, no chordee, and usually no effects in micturition or sexual physiology. However, quality of life and psychosexuality may be affected.
A 6-year-old-boy was referred by a general practitioner to the hospital due to an abnormality of the urethral meatus. The patient did not have any complaints. A large external urethral orifice at the ventral area of the coronal glans was discovered. The prepuce was normally-conformed, and there weren't any signs of chordee. The patient was diagnosed with an MIP hypospadias variant and underwent a tubularized incised plate (TIP) urethroplasty. During the follow-up, one week after the procedure, the patient did not have any complaints. Physical examination showed excellent anatomical and functional outcome based on the cosmetic appearance resembling a normal penis and urinary stream.
Awareness regarding this abnormality is necessary as MIP is often not diagnosed until circumcision. Even though MIP patients are usually asymptomatic, surgery should still be considered based on aesthetic and psychosexual reasons. TIP urethroplasty was chosen for this patient based on the clinical findings of this patient. TIP procedure for MIP patients could result in an excellent penile performance and function with a very low complication rate.
TIP urethroplasty is able to fulfil satisfactory cosmetic and functional outcomes for the MIP hypospadias variant. Awareness of the disorder should be increased to prevent potential psychosexual disturbances.
尿道口完整包皮（MIP）是尿道下裂的一种罕见变异型，其特征为尿道口宽大，包皮形态正常，无阴茎下弯，通常对排尿或性生理无影响。然而，生活质量和心理性征可能会受到影响。
一名6岁男孩因尿道口异常被全科医生转诊至我院。患者无任何不适主诉。检查发现冠状沟龟头腹侧有一个大的尿道外口。包皮形态正常，无阴茎下弯迹象。该患者被诊断为MIP型尿道下裂变异型，并接受了管状切开板（TIP）尿道成形术。术后随访期间，术后一周患者无任何不适主诉。体格检查显示，基于外观类似正常阴茎和尿流情况，手术取得了良好的解剖和功能效果。
由于MIP通常在包皮环切术后才被诊断出来，因此有必要提高对这种异常情况的认识。尽管MIP患者通常无症状，但基于美学和心理性征原因仍应考虑手术治疗。根据该患者的临床表现，选择了TIP尿道成形术。对MIP患者实施TIP手术可取得良好的阴茎外观和功能，且并发症发生率极低。
TIP尿道成形术能够为MIP型尿道下裂变异型患者带来满意的美容和功能效果。应提高对该疾病的认识，以预防潜在的心理性征障碍。
