Arap S, Nahas W C, Giron A M, Bruschini H, Mitre A I
Clinica Urologica do Hospital das Clinicas da Faculdade de Medicina, da Universidade de Sao Paulo, Brazil.
J Urol. 1988 Sep;140(3):577-81. doi: 10.1016/s0022-5347(17)41723-x.
We review 38 cases of surgically corrected incontinent epispadias with a followup of 5 months to 18 years. In 20 cases the Leadbetter, in 8 the Tanagho and in 8 the Young-Dees techniques of bladder neck reconstruction were used. Of 3 patients with minimal (15 to 25 ml.) bladder capacity the Arap procedure was performed in 1, while small constriction of the bladder neck to improve the bladder capacity and compliance was done in 2. In 1 of the latter patients a 60 ml. capacity was achieved and a secondary Leadbetter operation provided an excellent result. Continence was attained after the initial operation in 18 patients, followup is too short to determine the result in 3 and 15 did not acquire urinary control. Revision of the bladder neck plasty was performed in 11 patients, which resulted in continence in 4 and partial continence in 2. Among 34 patients with an adequate followup 22 (73.3 per cent) are continent and 8 (26.4 per cent) are incontinent. The results were similar with the 3 techniques.
我们回顾了38例经手术矫正的失禁型尿道上裂病例，随访时间为5个月至18年。其中20例采用了利德贝特（Leadbetter）技术，8例采用了塔纳戈（Tanagho）技术，8例采用了扬-迪斯（Young-Dees）膀胱颈重建技术。3例膀胱容量极小（15至25毫升）的患者中，1例接受了阿拉普（Arap）手术，另外2例则对膀胱颈进行了小范围缩窄以改善膀胱容量和顺应性。在后2例患者中，1例患者的膀胱容量达到了60毫升，二次利德贝特手术取得了极佳效果。18例患者在初次手术后实现了控尿，3例患者的随访时间过短无法确定结果，15例患者未获得尿液控制能力。11例患者进行了膀胱颈成形术的修复，其中4例实现了控尿，2例部分控尿。在34例有足够随访时间的患者中，22例（73.3%）实现了控尿，8例（26.4%）仍失禁。三种技术的结果相似。
