Diamond D A, Ransley P G
J Urol. 1986 Jul;136(1 Pt 2):252-5. doi: 10.1016/s0022-5347(17)44831-2.
A new method of bladder neck reconstruction in which the Young-Dees tube was wrapped with omentum and silicone was used in 39 patients during a 20-month period. In 43 per cent of the patients simultaneous augmentation cystoplasty also was performed. The silicone was intended to maintain the Young-Dees tube length and to allow safe artificial sphincter cuff placement later when necessary. Among exstrophy patients 85 per cent of those who underwent augmentation and 15 per cent of those who did not are dry. A dry exstrophy patient had a remarkably easy sphincter cuff placement 6 months after bladder neck reconstruction. Of the epispadias patients 25 per cent are dry and 58 per cent have a dry interval of 2 hours or less. Erosion of silicone into the Young-Dees tube occurred in the first 5 patients in whom a thick (0.01-inch) wrap was used and in 14 per cent of those in whom a thin (0.005-inch) sheet was used. The details of this technique and modifications to reduce further the complication rate are discussed.
一种新的膀胱颈重建方法，即在20个月期间对39例患者采用大网膜包裹Young-Dees管并使用硅胶。43%的患者同时进行了膀胱扩大术。使用硅胶的目的是保持Young-Dees管的长度，并在必要时便于后期安全放置人工括约肌袖带。在膀胱外翻患者中，接受膀胱扩大术的患者有85%无尿失禁，未接受膀胱扩大术的患者有15%无尿失禁。膀胱颈重建术后6个月，无尿失禁的膀胱外翻患者放置括约肌袖带非常容易。在尿道上裂患者中，25%无尿失禁，58%的患者无尿失禁的间隔时间为2小时或更短。在最初使用厚（0.01英寸）包裹的5例患者以及使用薄（0.005英寸）薄片的患者中有14%出现硅胶侵蚀进入Young-Dees管的情况。本文讨论了该技术的细节以及为进一步降低并发症发生率而进行的改进。
