Kramer S A, Aydin G, Kelalis P P
J Urol. 1982 Sep;128(3):559-61. doi: 10.1016/s0022-5347(17)53045-1.
We discuss 20 children who have undergone surgical correction of chordee without hypospadias. In 9 patients ventral curvature was demonstrated secondary to corporeal disproportion, 8 had chordee secondary to deficiency of the dartos fascia (skin chordee) and 3 had deficiency of the dartos and Buck's fasciae. Eight patients underwent excision of dorsal ellipses according to the Nesbit principle, 8 had lysis of the dartos fascia using the Allen-Spence technique, 2 underwent mobilization of the urethra with excision of underlying fibrous tissue and 2 had division of the urethra with a staged urethroplasty. The majority of cases of chordee without hypospadias are a result of anomalies of the tissue layers of the penis, and adequate straightening can be achieved by excision of underlying abnormal fascial tissue. All patients have achieved a satisfactory cosmetic and functional result with a straight penis and a urethral meatus positioned distally at the glans tip.
我们讨论了20例未合并尿道下裂而行阴茎下弯手术矫正的患儿。9例患者的腹侧弯曲是由于海绵体不对称所致,8例因肉膜筋膜缺乏(皮肤性阴茎下弯)导致阴茎下弯,3例存在肉膜和白膜筋膜缺乏。8例患者根据内斯比特原则行背侧椭圆形切除,8例采用艾伦 - 斯彭斯技术行肉膜筋膜松解,2例在切除其下纤维组织的同时进行尿道游离,2例行尿道离断并分期尿道成形术。大多数未合并尿道下裂的阴茎下弯病例是阴茎组织层异常所致,通过切除其下异常筋膜组织可实现充分矫直。所有患者均获得了满意的外观和功能效果,阴茎伸直,尿道口位于龟头顶端远端。