Vyas P R, Roth D R, Perlmutter A D
J Urol. 1987 Mar;137(3):471-4. doi: 10.1016/s0022-5347(17)44071-7.
A total of 33 patients underwent hypospadias or epispadias repair by patch or tubular grafts of skin or bladder epithelium from July 1980 to January 1985. Indications included previous circumcision, proximal primary hypospadias, severe chordee alone, inadequate local skin during extended urethroplasty at 2-stage hypospadias repair, multiple previous reconstructions and failed epispadias repair. Genital skin grafts were used in 25 patients, extragenital skin grafts in 4 and bladder epithelial grafts in 4. Complications occurred in 13 patients (39.4 per cent): 8 required reoperation for a fistula, stricture or diverticulum, and 5 underwent internal urethrotomy or urethral dilation. Of the 8 patients 3 needed more than 1 revision. These revisions were short and generally uncomplicated. Final results uniformly were good functionally and cosmetically. Based on our experience and that of others we believe that despite a high incidence of minor complications a free graft serves as an excellent substitute urethra for treatment of a variety of urethral problems in children.
1980年7月至1985年1月，共有33例患者接受了采用皮肤或膀胱上皮补片或管状移植物的尿道下裂或尿道上裂修复术。适应证包括既往包皮环切术、近端原发性尿道下裂、单纯重度阴茎下弯、二期尿道下裂修复术中尿道成形术时局部皮肤不足、既往多次重建手术及尿道上裂修复术失败。25例患者使用了生殖器皮肤移植物，4例使用了生殖器外皮肤移植物，4例使用了膀胱上皮移植物。13例患者（39.4%）出现并发症：8例因瘘管、狭窄或憩室需要再次手术，5例接受了内尿道切开术或尿道扩张术。8例患者中有3例需要不止1次修复。这些修复手术时间短，一般无并发症。最终结果在功能和外观上均良好。根据我们和其他人的经验，我们认为尽管轻微并发症发生率较高，但游离移植物是治疗儿童各种尿道问题的理想替代尿道。
