Sensöz O, Celebioğlu S, Baran C N, Koçer U, Tellioğlu A T
Department of Plastic and Reconstructive Surgery, Ankara Numune Hospital, Turkey.
Plast Reconstr Surg. 1997 Jan;99(1):93-8; discussion 99. doi: 10.1097/00006534-199701000-00014.
We report on a new modification technique and the latest results of a procedure for treating cases of distal hypospadias with minimal or no chordee called advancement of a distally deepithelialized urethrocutaneous flap. This procedure incorporates correction of chordee, mobilization of the urethrocutaneous flap, and advancement of the flap through a tunnel until it reaches the tip of the glans. A total of 30 children underwent treatment using this procedure in our clinic. Follow-up of the patients ranged from 2 months to 3 years. Cosmetic results were excellent in all the patients. Fistula formation has been observed in only one patient, possibly due to a surgical accident. This technique may only be applied in distal hypospadias patients with minimal or no chordee in whom the meatus is localized to the coronal level or 0.5 cm proximal to it. Patients with a short urethra or in whom the meatus is distally localized but with severe chordee are not candidates for this technique. In general, this technique is not applicable in patients with ventral penile curvature. We would like to emphasize that this repair technique allows for simple and safe dissection of the distal urethra composed of only mucosa without corpus spongiosum around it. This kind of distal urethra can be advanced easily to the tip of the glans penis with the help of the dermal component.
我们报告了一种新的改良技术以及一种治疗远端尿道下裂病例（阴茎弯曲最小或无阴茎弯曲）的手术的最新结果，该手术称为远端去上皮尿道皮瓣推进术。此手术包括阴茎弯曲矫正、尿道皮瓣游离以及皮瓣通过隧道推进直至到达龟头顶端。在我们诊所，共有30名儿童接受了该手术治疗。患者的随访时间为2个月至3年。所有患者的美容效果均极佳。仅1例患者出现瘘管形成，可能是由于手术意外。该技术仅适用于阴茎弯曲最小或无阴茎弯曲、尿道口位于冠状沟水平或其近端0.5厘米处的远端尿道下裂患者。尿道短或尿道口位于远端但阴茎弯曲严重的患者不适合该技术。一般来说，该技术不适用于阴茎腹侧弯曲的患者。我们想强调的是，这种修复技术允许对仅由黏膜组成且周围无海绵体的远端尿道进行简单而安全的解剖。借助真皮成分，这种远端尿道可轻松推进至阴茎龟头顶端。
