尿道重建术治疗中远端尿道下裂伴痛性勃起248例
作者：Joel F. Koenig, Michael Kottwitz, Patrick H. McKenna 来源：Journal of Urology 日期：2013-02-25
导读
Urethral Mobilization for Distal and Midshaft Hypospadias with Chordee
Abstract
Purpose
Many options are available for the repair of midshaft to distal hypospadias. Reported complications include poor cosmetic appearance, persistence of chordee, meatal stenosis, and fistula. We hypothesize that advancing intact native urethra will facilitate correction of chordee and minimize complications.
Methods
We retrospectively reviewed our records of all 248 hypospadias repairs from July 2003 to May 2009 and identified patients less than 18 years old with distal or midshaft hypospadias who were repaired by urethral mobilization. The outcomes recorded were patient satisfaction, bladder scan volume, and rates of fistulae, meatal stenosis or other complications.
Results
Eighty-three patients met inclusion criteria. Five (6%) patients had previous, failed hypospadias operations. Hypospadias location was distal, midshaft, and megameatus intact prepuce variant in 69 (83.1%), 11 (13.3%), 3 (3.6%) patients respectively. Chordee was present in 80 patients (96.4%). Mean degree of chordee was 61.5 degrees. Mean age at operation was 35.7 months. Mean follow-up was 18 (0.25 to 79) months. Ninety-three precent of parental responses were “pleased” or “very pleased”. Mean bladder scan was 9.7ml (range 0 to 81ml). One patient (1.2%) developed a fistula. There were no cases of meatal stenosis.
Conclusions
Urethral mobilization results in an excellent cosmetic appearance and low complication rate. This technique is especially well suited for patients with prior operations or who have a deficiency of preputial skin. Utilizing the native urethra with its own blood supply is our preferred method for repairing distal and midshaft hypospadias with chordee.
http://www.jurology.com/article/S0022-5347(13)00311-X/abstract
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