Keramidas D C, Soutis M E
2nd Department of Pediatric Surgery, Aghia Sophia Children's Hospital, Athens, Greece.
Eur J Pediatr Surg. 1995 Dec;5(6):348-51. doi: 10.1055/s-2008-1066240.
One hundred and thirty boys with subcoronal (78) and subglandular (52) hypospadias were submitted to Urethral Advancement, Glanduloplasty and Preputioplasty (URAGP). The main steps of the operation were the following: blunt dissection and mobilization of the urethra as extensively as needed to reach the tip of the glans without tension; embedding of the urethra into a groove of the glans created by excision of tissue between two incisions converging from each side of the primary meatal location up to the tip of the glans; fixation of the meatus up to the tip of the glans and suturing of the glandular flaps over the mobilized urethra; shaping the foreskin to normal appearance. Reconstruction was uncomplicated in 117 patients (90%). Postoperative fistulae and urethral retraction to an abnormal position occurred in 7 and 6 cases respectively. All meatal retractions and 2 fistulae next to the meatus were dealt with successfully using the Mathieu procedure. On the basis of this experience we conclude that the technique is applicable to any type of distal hypospadias regardless of the severity of glandular ventriflexion, it is amenable to the Mathieu procedure in case of failure and gives good functional and cosmetic results.
130例患有冠状沟下型（78例）和阴茎头下型（52例）尿道下裂的男孩接受了尿道前移、阴茎头成形术和包皮成形术（URAGP）。手术的主要步骤如下：钝性分离并尽可能广泛地游离尿道，以无张力地到达阴茎头顶端；将尿道嵌入由从原尿道口两侧向阴茎头顶端汇合的两个切口之间切除组织所形成的阴茎头沟内；将尿道口固定至阴茎头顶端，并在游离的尿道上缝合阴茎头皮瓣；将包皮整形成正常外观。117例患者（90%）的重建过程顺利。术后分别有7例和6例出现瘘管和尿道退缩至异常位置。所有尿道口退缩和尿道口旁的2例瘘管均通过Mathieu手术成功处理。基于这一经验，我们得出结论，该技术适用于任何类型的远端尿道下裂，无论阴茎头腹侧弯曲的严重程度如何，失败时可采用Mathieu手术，并且能取得良好的功能和美容效果。
