Jayanthi V R, McLorie G A, Khoury A E, Churchill B M
Hospital for Sick Children, Toronto, Ontario, Canada.
J Urol. 1994 Aug;152(2 Pt 2):740-3; discussion 743. doi: 10.1016/s0022-5347(17)32695-2.
Between 1986 and 1992, 39 boys underwent 44 pedicle flap urethroplasties as a salvage procedure using penile skin that had been relocated during prior hypospadias repair(s). All previous operations had resulted in a meatus in an unacceptable position. The salvage pedicle flap procedure used for these boys was either a Mathieu urethroplasty or an island flap repair. Of 28 patients who underwent salvage Mathieu urethroplasty 20 (71%) required no further surgery, 4 had strictures or fistulas repaired and 4 (14%) required further urethral reconstruction, including 1 island flap and 2 Mathieu operations. Of 16 boys who underwent salvage island flap procedures 7 (43%) required no further treatment, 4 had fistulas, 2 had had urethral strictures and 4 had a subcoronal meatus, of whom 3 underwent further urethral reconstruction, including 2 Mathieu and 1 Thiersch-Duplay operations. We defined overall success as ultimately having a functional urethra without persistent fistulas or strictures and a cosmetically acceptable glanular meatus. Excluding 2 patients who are awaiting fistula repair, 34 of 37 evaluable cases (92%) were successfully repaired. We conclude that relocated penile skin can be used successfully to base a pedicle flap for salvage hypospadias repair.
1986年至1992年间，39名男孩接受了44次带蒂皮瓣尿道成形术，作为一种补救手术，使用的是在先前尿道下裂修复术中重新定位的阴茎皮肤。所有先前的手术均导致尿道口位置不理想。用于这些男孩的补救性带蒂皮瓣手术为马蒂厄尿道成形术或岛状皮瓣修复术。在接受补救性马蒂厄尿道成形术的28例患者中，20例（71%）无需进一步手术，4例进行了狭窄或瘘管修复，4例（14%）需要进一步的尿道重建，包括1例岛状皮瓣手术和2例马蒂厄手术。在接受补救性岛状皮瓣手术的16名男孩中，7例（43%）无需进一步治疗，4例有瘘管，2例有尿道狭窄，4例有冠状沟下尿道口，其中3例进行了进一步的尿道重建，包括2例马蒂厄手术和1例蒂尔施-迪普莱手术。我们将总体成功定义为最终拥有一个功能正常的尿道，无持续性瘘管或狭窄，且尿道口外观可接受。排除2例等待瘘管修复的患者，37例可评估病例中有34例（92%）成功修复。我们得出结论，重新定位的阴茎皮肤可成功用于构建带蒂皮瓣，以进行补救性尿道下裂修复。
