Urology, Urology and Nephrology Hospital, Minia University, Minia Governorate, Minia, Egypt.
Urology, Urology and Nephrology Hospital, Minia University, School of Medicine, Minia University, Minia, Egypt.
J Pediatr Surg. 2022 Jul;57(7):1404-1408. doi: 10.1016/j.jpedsurg.2021.05.024. Epub 2021 Jun 5.
We present our modified technique of using the inner preputial flap to cover the penile shaft, while removing the subcutaneous tissue of the distal part of the flap to act similar to graft. Herein, we present our experience with modified two stage inner preputial flap for repair of proximal hypospadias with chordee.
The current study was a single-institution retrospective study between January 2016 and December 2020. Thirty-one patients with proximal hypospadias with chordee were included and underwent our modified technique. We excluded re-operative hypospadias and incomplete follow-up cases (<6 month of follow up). Patient demographics, outcomes and complications in the form of fistula formation, diverticulum, metal stenosis, stricture formation and glans dehiscence were reviewed.
A total of 31 patients were included in the study and underwent our modified technique. The median age was 18 months (9-60) & IQR 15-25). The median follow up was 40 months. Overall, success was achieved in 24 cases (77.4%). Complications occurred in seven cases (22.6%) and included urethrocutanous fistula in three patients (9.7%), diverticulum in two patients (6.5.%), metal stenosis in one patient (3.2%) and glans dehiscence in one patient (3.2%).
Our technique provides a favourable outcome with a low complication rate for repair of proximal severe hypospadias.
Case Series Study (Level IV).
我们介绍了一种改良技术，使用内包皮瓣覆盖阴茎干，同时去除瓣的远端皮下组织，使其起到移植物的作用。在此，我们介绍了改良的两阶段内包皮瓣在修复近端伴有弯曲的尿道下裂的经验。
本研究为 2016 年 1 月至 2020 年 12 月期间的单机构回顾性研究。纳入 31 例近端伴有弯曲的尿道下裂患者，并采用我们的改良技术进行治疗。我们排除了再次手术的尿道下裂和随访不完整的病例（<6 个月的随访）。回顾了患者的人口统计学数据、结局和并发症情况，包括瘘管形成、憩室、金属狭窄、狭窄形成和龟头裂开。
共有 31 例患者纳入研究并接受了我们的改良技术。患者的中位年龄为 18 个月（9-60），IQR 为 15-25。中位随访时间为 40 个月。总体而言，24 例（77.4%）获得成功。7 例（22.6%）出现并发症，包括 3 例（9.7%）尿道皮肤瘘、2 例（6.5%）憩室、1 例（3.2%）金属狭窄和 1 例（3.2%）龟头裂开。
我们的技术为修复严重近端尿道下裂提供了良好的结果，并发症发生率低。
病例系列研究（IV 级）。
