Kajbafzadeh A M, Duffy P G, Ransley P G
Department of Pediatric Urology, Hospital for Sick Children, London, United Kingdom.
J Urol. 1995 Aug;154(2 Pt 2):858-61. doi: 10.1097/00005392-199508000-00144.
From 1978 to 1993, 180 boys with epispadias (85) and the exstrophy/epispadias complex (95) underwent epispadias reconstruction at our institution. The 180 patients were divided into 4 groups: group 1--2-stage epispadias reconstruction with dissection of the corporo (30 patients), group 2--pedicled preputial tube urethroplasty either alone or with a lyophilized human dural patch to the corpora for correction of penile deformity (35), group 3--pedicled preputial tube urethroplasty and corporeal rotation (40), and group 4--a modified Cantwell epispadias repair incorporating complete tubularized urethroplasty, cavernocavernostomy and corporeal rotation. In 46 patients from groups 1 to 3 the primary outcome was not considered satisfactory and they underwent radical penile revision with the modified Cantwell technique. Followup ranges from 1 to 15 years (mean 6 years). We conclude that a good cosmetic result can be achieved in almost all cases using the modified Cantwell technique as a primary procedure in experienced hands. This technique has a low complication rate and can be used as a salvage procedure following previous unsuccessful epispadias reconstruction using other techniques.
1978年至1993年期间，180例患有尿道上裂（85例）和膀胱外翻/尿道上裂综合征（95例）的男孩在我院接受了尿道上裂修复手术。这180例患者被分为4组：第1组——采用阴茎海绵体分离术的两阶段尿道上裂修复术（30例患者），第2组——单独使用带蒂包皮管尿道成形术或联合冻干人硬脑膜补片修复阴茎海绵体以矫正阴茎畸形（35例），第3组——带蒂包皮管尿道成形术及阴茎海绵体旋转术（40例），第4组——改良的坎特韦尔尿道上裂修复术，包括完全管状化尿道成形术、海绵体海绵体吻合术及阴茎海绵体旋转术。第1至3组中的46例患者的主要手术效果未达满意，遂采用改良的坎特韦尔技术进行了阴茎根治性修复。随访时间为1至15年（平均6年）。我们得出结论，在经验丰富的医生手中，将改良的坎特韦尔技术作为主要手术方法，几乎在所有病例中均可获得良好的美容效果。该技术并发症发生率低，可作为先前采用其他技术进行尿道上裂修复手术失败后的补救手术方法。
