Maizels M, Firlit C F
J Urol. 1986 Apr;135(4):752-4. doi: 10.1016/s0022-5347(17)45840-x.
Since July 1982, 23 children between 10 and 28 months old underwent correction of hypospadias. After chordee was resected the urethral orifice was in the perineum in 3, at the penoscrotal junction in 5, on the proximal or mid shaft in 10 or at the distal shaft in 5. The neourethra was fashioned from a transverse island pedicle of preputial skin for proximal hypospadias or by using Mustarde's technique for distal hypospadias. A perforated silicone tube was left in the urethra and a feeding tube was passed through the lumen of the urethral stent to drain the bladder. Up to 4 days later the bladder catheter was removed and the children voided per the neourethra. The urethral stent was removed between 6 and 30 days postoperatively. Voiding through a recently constructed urethra was well tolerated. The boys did not experience bladder spasms, urinary extravasation did not occur and cosmetic results were good. Meatal stenosis did not occur. Three children (13 per cent) required closure of a fistula, which was noted 1 to 2 1/2 years later. It appears that briefly diverting bladder urine after hypospadias repair ameliorated postoperative morbidity without compromising the results. This technique was found to be inappropriate in older boys because of significant dysuria.
自1982年7月以来，23名年龄在10至28个月的儿童接受了尿道下裂矫正术。切除阴茎弯曲后，尿道口位于会阴部的有3例，位于阴茎阴囊交界处的有5例，位于阴茎近端或中段的有10例，位于阴茎远端的有5例。对于近端尿道下裂，采用包皮皮肤的横向岛状带蒂皮瓣形成新尿道；对于远端尿道下裂，则采用马斯塔德技术。在尿道内留置一根带孔硅胶管，并通过尿道支架的内腔插入一根饲管以引流膀胱。最多4天后拔除膀胱导管，患儿通过新尿道排尿。术后6至30天取出尿道支架。通过新构建的尿道排尿耐受性良好。患儿未出现膀胱痉挛，未发生尿外渗，外观效果良好。未发生尿道口狭窄。3名患儿（13%）需要在1至2年半后闭合发现的瘘管。尿道下裂修复术后短暂改道膀胱尿液似乎减轻了术后发病率，且不影响手术效果。由于明显的排尿困难，该技术在年龄较大的男孩中被发现不合适。
