Schumacher S, Yabumoto H, Salge S, Shrestha G, Ikoma F
Department of Urology, Hyogo College of Medicine, Nishinomiya, Japan.
Int Urol Nephrol. 1997;29(3):333-40. doi: 10.1007/BF02550932.
Between 1980 and 1992, 403 patients with hypospadias and with no previous operations were treated in Hyogo College of Medicine. Surgery was not performed in children younger than 3 years. The major points in the surgical repair were complete resection of the chordee, normal location of the meatus and reducing complications such as fistula formation or stricture. In order to achieve these aims we performed a two-stage repair, with the second operation at leat 12 months after the first one. In 57 of 245 patients with "chordee without hypospadias" and slight to moderate degree of hypospadias we performed surgery by the Crawford-Ikoma technique, which is characterized by 3 layers of watertight continuous sutures at the time of urethroplasty. The incidence of postoperative fistulae was 1.8%, the rate of strictures was 3.5%. After the Mays-Ikoma technique, where we perform a glandular urethroplasty in addition to chordectomy in the first stage, we diagnosed an urethral fistula in 7.9% and a stricture in 2.3%. A severe degree of hypospadias was seen in 158 patients. After performing the Crawford-Ikoma technique we acknowledged a rate of postoperative fistulae in 3.6% and strictures in 10.7%. The incidence of fistulae after the Mays-Ikoma technique was 8.9% and of strictures 1.1%. Altogether we found persistent chordee in 2 cases.
1980年至1992年间，兵库医科大学对403例未曾接受过手术的尿道下裂患者进行了治疗。3岁以下儿童未进行手术。手术修复的要点是完全切除阴茎下弯、尿道口正常定位以及减少诸如瘘管形成或狭窄等并发症。为了实现这些目标，我们采用了两阶段修复，第二次手术在第一次手术后至少12个月进行。在245例“无尿道下裂的阴茎下弯”且尿道下裂程度为轻度至中度的患者中，有57例我们采用了克劳福德-池间技术进行手术，该技术的特点是在尿道成形术时进行三层水密连续缝合。术后瘘管发生率为1.8%，狭窄率为3.5%。在梅斯-池间技术（即在第一阶段除阴茎下弯切除术外还进行阴茎头尿道成形术）之后，我们诊断出尿道瘘的发生率为7.9%，狭窄率为2.3%。158例患者存在重度尿道下裂。采用克劳福德-池间技术后，我们发现术后瘘管发生率为3.6%，狭窄率为10.7%。梅斯-池间技术后的瘘管发生率为8.9%，狭窄率为1.1%。我们总共发现2例持续性阴茎下弯。
