Kramer S A, Mesrobian H G, Kelalis P P
J Urol. 1986 Mar;135(3):543-7. doi: 10.1016/s0022-5347(17)45731-4.
In male patients who undergo surgery for epispadias the major postoperative complaint often concerns the cosmetic appearance of the penis and the failure to correct the dorsal chordee rather than the urinary incontinence. In the past straightening and lengthening of the penis were not given adequate consideration, and penile elongation was limited to release of dorsal skin chordee only. Recently, however, additional penile length has been achieved by partial mobilization of the crura of the corpora cavernosa from the pubic rami. In a series of 70 patients penile lengthening and urethroplasty were performed separately or were combined as a 1-stage procedure with full thickness grafts or preputial flaps. The recent use of hair-bearing groin flaps has provided excellent skin coverage for the large dorsal defect at the penoabdominal angle. A satisfactory cosmetic appearance of the external genitalia, with a straight penis angulated downward in the standing position, was achieved in 67 per cent of the patients. Normal erectile function was preserved in all patients, 80 per cent of whom have had a straight penis with erection and satisfactory intercourse. Of the patients 29 are married and 19 have fathered children. Meticulous attention to the technical aspects of reconstructive surgery usually can result in a gratifying cosmetic appearance, normal genital function and preservation of fertility potential in most patients.
在接受尿道上裂手术的男性患者中，术后主要的抱怨往往涉及阴茎的外观以及未能矫正阴茎背侧弯曲，而非尿失禁。过去，阴茎的伸直和延长未得到充分考虑，阴茎延长仅限于松解阴茎背侧皮肤索带。然而，最近通过将阴茎海绵体脚从耻骨支部分游离，实现了额外的阴茎长度增加。在一组70例患者中，阴茎延长术和尿道成形术分别进行，或作为一期手术联合全厚皮片或包皮瓣进行。最近使用带毛发的腹股沟皮瓣为阴茎腹角处的大的背侧缺损提供了良好的皮肤覆盖。67%的患者实现了外生殖器令人满意的外观，阴茎在站立位时笔直且向下成角。所有患者均保留了正常的勃起功能，其中80%的患者阴茎勃起时笔直且性交满意。在这些患者中，29人已婚，19人已育有子女。对重建手术技术细节的精心关注通常可使大多数患者获得令人满意的外观、正常的生殖功能并保留生育潜力。
