Perovic S V, Vukadinovic V, Djordjevic M L, Djakovic N
Department of Urology, University Children's Hospital, Belgrade, Yugoslavia.
Br J Urol. 1998 Mar;81(3):479-87. doi: 10.1046/j.1464-410x.1998.00547.x.
To report experience and results with penile disassembly in hypospadias repair.
From November 1995 to May 1997 penile disassembly was used in 92 patients aged from 9 months to 32 years. The indications for operation were hypospadias with severe penile curvature (especially with curvature in the distal third of the corpora cavernosa), chordee without hypospadias, and small penis with hypospadias. The technique involves separating the penis into its component parts, i.e. the glans cap with neurovascular bundle dorsally, together with the undivided or divided urethra and urethral plate ventrally, and the corpora cavernosa. The manoeuvre allows any curvature to be corrected, especially when in the distal third of the corporal bodies, glans tilt to be rectified, and the penis to be enlarged, particularly elongated, which is a significant gain in small penises with hypospadias.
The patients were followed for 3-20 months (mean 14); the penis was straightened in all cases, with no recurrence of curvature. In 37 patients (40%) penile disassembly combined with extensive urethral mobilization resolved the hypospadiac meatus with no need to form a neourethra; the penis was larger after surgery. Complications were related to urethroplasty and included four urethral stenoses, two fistulae and three diverticula. There was no injury to the neurovascular bundle and urethra; sensitivity and erection were preserved in all patients.
The penile disassembly technique is most effective for hypospadias with severe curvature, especially for glans tilt and curvature located distally. Penile augmentation is possible using this technique.
报告阴茎解体术在尿道下裂修复中的经验及结果。
1995年11月至1997年5月，对92例年龄从9个月至32岁的患者采用阴茎解体术。手术适应证为伴有严重阴茎弯曲的尿道下裂（尤其是阴茎海绵体远端三分之一处弯曲）、无尿道下裂的阴茎下弯以及合并尿道下裂的小阴茎。该技术包括将阴茎分离为其组成部分，即背侧带有神经血管束的龟头帽，连同腹侧未分开或已分开的尿道及尿道板，以及阴茎海绵体。此操作可矫正任何弯曲，尤其是当弯曲位于阴茎海绵体远端三分之一处时，可纠正龟头倾斜，并增大阴茎，特别是延长阴茎，这对于合并尿道下裂的小阴茎而言是显著的改善。
患者随访3至20个月（平均14个月）；所有病例阴茎均伸直，无弯曲复发。37例患者（40%）采用阴茎解体术联合广泛尿道游离术，无需形成新尿道即可解决尿道下裂尿道口问题；术后阴茎增大。并发症与尿道成形术相关，包括4例尿道狭窄、2例瘘管和3例憩室。神经血管束和尿道未受损伤；所有患者的感觉和勃起功能均得以保留。
阴茎解体术对于伴有严重弯曲的尿道下裂最为有效，尤其是对于龟头倾斜和远端弯曲。采用该技术可增大阴茎。
