Bruézière J
Service d'Urologie, Hôpital Trousseau, Paris.
Ann Urol (Paris). 1996;30(4):201-3.
Thirty six fistulas after hypospadias reconstruction, were operated on from 1989 to 1994. The procedure depends on the anatomical aspect of fistula. Simple fistulas of penis (33 cases) were operated by direct suture with two or three layers. In 21 cases, suture with three layers without tube obtained 19 successes. In 12 cases, suture with two layers, with or without tube, obtained 6 successes; complex penile fistulas, after repeated procedures, need a penioscrotal sinking (Leveuf procedure; one case, on success); granular fistulas need excision of tissues between fistula and new meatus. Reconstruction depends on the position of fistula: Mathieu procedure or advancement (two cases with two successes). In conclusion, 90% of fistulas are cured in one intervention without tube, on an outpatient basis.
1989年至1994年期间,对36例尿道下裂重建术后的瘘管进行了手术治疗。手术方法取决于瘘管的解剖情况。阴茎单纯瘘管(33例)采用两层或三层直接缝合。21例三层无管缝合获得19例成功。12例两层缝合,有管或无管,获得6例成功;复杂阴茎瘘管经反复手术后,需要进行阴茎阴囊下沉术(勒弗夫手术;1例,1次成功);颗粒状瘘管需要切除瘘管与新尿道口之间的组织。重建取决于瘘管的位置:马蒂厄手术或推进术(2例,2次成功)。总之,90%的瘘管在一次无管门诊手术中治愈。