Piró C, de Diego M, Martín J A, Isnar R, Gosálbez R, Biox-Ochoa J
Hospital Materno-Infantil Vall d'Hebrón, Barcelona.
Cir Pediatr. 1998 Apr;11(2):71-2.
Proximal hypospadias are a difficult surgical problem, whether it could take place different surgical approaches. One of those is based on the creation of a neourethra using a free buccal mucosal graft, as a patch or a tube, obtained from de lips or cheek. Since 1983 we have been using this technique in 8 patients. The urethral meatus was penoscrotal in 3, scrotal in 3 and perineal in 2. There was a significant chordee in 3 patients. Hormonal treatment was necessary in 5 patients. The average age for surgery was 3.5 years. The graft was tubularized in all the cases. The free buccal mucosal graft was combined with a distal Duckett procedure in 6 patients. Two patients received only a free buccal mucosal graft. The final result is satisfactory in all the cases, with a good urinary jet. The complications were 7 urethrocutaneous fistulas, 5 of whom needed a surgical repair, and 2 stenosis, which also needed surgical repair.
近端尿道下裂是一个棘手的外科问题，无论采用何种不同的手术方法。其中一种方法是使用取自唇部或颊部的游离颊黏膜移植物，制成补片或管道来构建新尿道。自1983年以来，我们已对8例患者采用了该技术。尿道口位于阴茎阴囊交界处的有3例，阴囊型的有3例，会阴型的有2例。3例患者存在明显的阴茎下弯。5例患者需要进行激素治疗。手术的平均年龄为3.5岁。所有病例均将移植物制成管道状。6例患者将游离颊黏膜移植物与远端达克特手术相结合。2例患者仅接受了游离颊黏膜移植物。所有病例的最终结果均令人满意，尿流良好。并发症包括7例尿道皮肤瘘，其中5例需要手术修复，以及2例狭窄，也需要手术修复。
