Jawad A J
Department of Surgery, King Saud University, College of Medicine, Riyadh, Kingdom of Saudi Arabia.
Int Urol Nephrol. 1997;29(6):681-6. doi: 10.1007/BF02552186.
Distal hypospadias is a commonly encountered anomaly. Since its innovation by Duckett the MAGPI procedure has become almost the standard operation for the correction of minor cases. Recently case selection has been advised to avoid possible complications and limitations. Between April 1986 and April 1995, 153 boys were treated for distal hypospadias. In 51 patients (coronal 31, subcoronal 20) a modified technique of urethral advancement and glanuloplasty (UAGP) has been used. The main indications of UAGP were the presence of glanular chordee (7), failed MAGPI (3), circumcised children with distal hypospadias (7), immobile fibrotic urethral meatus (5), and as an alternative to MAGPI (29). The overall complication rate was 4% compared to 3.8% with the MAGPI procedure which has been used in the treatment of 102 patients (glanular 50, coronal 47, and subcoronal 5). We feel this technique can be used effectively in patients with coronal and subcoronal hypospadias, particularly in the presence of distal chordee, fibrotic immobile urethral meatus or MAGPI limitations. Also UAGP could be a useful alternative to MAGPI where tension-free urethral advancement and glanular wrapping can be achieved.
远端尿道下裂是一种常见的异常情况。自达克特开创该手术以来，改良尿道口前移阴茎头成形术（MAGPI）已几乎成为矫正轻症病例的标准手术。近来，有人建议进行病例选择以避免可能出现的并发症和局限性。在1986年4月至1995年4月期间，153名男孩接受了远端尿道下裂的治疗。其中51例患者（冠状沟型31例，冠状沟下型20例）采用了改良的尿道前移和阴茎头成形术（UAGP）。UAGP的主要适应证包括阴茎头型阴茎下弯（7例）、MAGPI手术失败（3例）、行包皮环切术的远端尿道下裂患儿（7例）、固定不动的纤维化尿道口（5例）以及作为MAGPI手术的替代方法（29例）。与用于治疗102例患者（阴茎头型50例，冠状沟型47例，冠状沟下型5例）的MAGPI手术相比，UAGP的总体并发症发生率为4%，而MAGPI手术的并发症发生率为3.8%。我们认为，该技术可有效应用于冠状沟型和冠状沟下型尿道下裂患者，尤其是存在远端阴茎下弯、纤维化固定不动的尿道口或MAGPI手术存在局限性的情况。此外，在能够实现无张力尿道前移和阴茎头包裹的情况下，UAGP可能是MAGPI手术的一种有用替代方法。
