Peng Zhiwei, Huang Yichen, Chen Yan, Lyu Yiqing, Wu Min, Xie Hua, Chen Fang
Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
J Pediatr Urol. 2024 Feb;20(1):147-148. doi: 10.1016/j.jpurol.2023.09.011. Epub 2023 Sep 22.
To report a novel maneuver of end-to-side urethro-urethrostomy for managing Type IIA1 urethral duplication (UD).
A 3-years-old boy was referred to our institute for abnormal appearance of genitalia. Physical examination revealed an epispadiac meatus on the dorsum of the penile shaft, in addition to the orthotopic meatus at the tip of glans. He can void through both urethrae with continence (grade I). Voiding cystourethrography and the cystoscopy confirmed the Type IIA1 UD with two urethrae arising independently from the bladder neck. A novel maneuver of end-to-side urethro-urethrostomy transferring the dorsal urethra through the corpus cavernosa and anastomosing it to the posterior wall of the ventral urethra was successfully performed.
The urethral catheter was removed 2 weeks postoperatively. Neither urethral stricture nor fistula was noticed. After 1 year of followed-up, the boy can void fluently with continence (grade I). The Qmax was 10.4 ml/s.
Our maneuver of end-to-side urethro-urethrostomy for managing Type IIA1 UD was safe and effective, especially for the continent cases with the ectopic meatus on the penile shaft.
报告一种用于治疗IIA1型尿道重复畸形（UD）的新型端端尿道吻合术。
一名3岁男孩因生殖器外观异常转诊至我院。体格检查发现阴茎背侧有尿道上裂尿道口，此外龟头顶端还有正常位置的尿道口。他能通过两个尿道排尿且能控制排尿（I级）。排尿性膀胱尿道造影和膀胱镜检查证实为IIA1型UD，两个尿道独立起源于膀胱颈。成功实施了一种新型的端端尿道吻合术，即将背侧尿道穿过海绵体并与腹侧尿道后壁吻合。
术后2周拔除尿道导管。未发现尿道狭窄或瘘管。随访1年后，该男孩能流畅排尿且能控制排尿（I级）。最大尿流率为10.4毫升/秒。
我们用于治疗IIA1型UD的端端尿道吻合术安全有效，尤其适用于阴茎背侧有异位尿道口且能控制排尿的病例。
