Tubularized incised plate urethroplasty for proximal hypospadias
Tubularized incised plate urethroplasty for proximal hypospadias
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DOI：
10.1046/j.1442-2042.2002.00426.x
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发表时间：
2002-02-01
影响因子：
2.6
通讯作者：
Kohri, K
中科院分区：
文献类型：
--
作者：
Mizuno, K;Hayashi, Y;Kohri, K
目的：许多外科手术已被用于矫正远端尿道下裂。其中，管状切开钢板尿道成形术（Snodgrass手术）已成为修复远端尿道下裂的主要方法。我们将此手术应用于尿道下裂近端。方法：对3例近端尿道下裂患者行管状切开尿道板尿道成形术。切口位置为阴茎近端1个，阴囊缘1个，阴囊1个。做围周切口，两个辅助切口延伸至龟头尖端。将阴茎轴的皮肤游离剥离至阴茎阴囊连接处，并切除纤维组织带，直到近端海绵体完全暴露在阴囊内。然后从龟头尖端到尿道下道沿其中线切开尿道板，无张力地进行管化。神经尿道用从背侧皮肤或阴囊皮肤上剥离的皮下组织蒂覆盖，以避免瘘管形成。结果：对3例近端尿道下裂患者行管状切开尿道板尿道成形术，一期成功。结论：Snodgrass手术适用于尿道板健康患者尿道下裂的矫正。它也适用于尿道下裂近端患者。
Objectives: Numerous surgical procedures have been used to correct distal hypospadias. Among them, the tubularized incised plate urethroplasty (Snodgrass procedure) has become a mainstay for the repair of distal hypospadias. We applied the procedure to proximal hypospadias.Methods: Three patients with proximal hypospadias underwent a tubularized incised urethral plate urethroplasty. The location of the meatus was proximal penis in one, penoscrotal margin in one and scrotum in one. A perimeatal incision was made and the two paramedian incisions were extended to the tip of the glans. The skin of the penile shaft was dissected free to the penoscrotal junction and bands of fibrous tissue were excised until the corpus spongiosum proximal to the meatus was completely exposed inside the scrotum. The urethral plate was then incised in its midline from the tip of the glans to the hypospadiac meatus and was tubularized without tension. The neourethra was covered with a pedicle of subcutaneous tissue dissected from the dorsal skin or the scrotal skin to avoid fistula formation.Results: The tubularized incised urethral plate urethroplasty was carried out successfully in one stage on three patients with proximal hypospadias.Conclusions: The Snodgrass procedure is suitable for correcting hypospadias in patients with a healthy urethral plate. It is also suitable in patients with proximal hypospadias.