Oral mucosa prefabricated urethra in the treatment of complicated hypospadias in adult patients
10.3760/cma.j.cn114453-20210611-00259
- VernacularTitle:口腔黏膜预构尿道在成人复杂型尿道下裂修复中的应用
- Author:
Sisi LUO
1
;
Qi WU
;
Yangqun LI
;
Zhe YANG
;
Ning MA
;
Weixin WANG
;
Sen CHEN
Author Information
1. 中国医学科学院北京协和医学院整形外科医院整形二科，北京 100144
- Keywords:
Hypospadias;
Repeated operation;
Oral mucosa;
Prefabricated urethra
- From:
Chinese Journal of Plastic Surgery
2022;38(8):887-891
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To review the clinical effect of oral mucosa prefabricated urethra in the treatment of complicated hypospadias in adult patients.Methods:A retrospective analysis was performed on adult patients with complicated hypospadias who underwent two-stage surgical repair in the Second Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2011 to December 2020. In the first stage, the urethra was prefabricated with oral mucosa, which was 5.0-6.0 cm in length and 1.0-1.2 cm in width. The second stage was urethral anastomosis, in which scrotal flap was applied to cover the wound. Postoperative follow-up was conducted by telephone or WeChat, including penile appearance and the situation of urination.Results:A total of 114 patients were enrolled, age raging from 18 to 63 years old, with an average age of 28 years. There were 22 cases who had underwent one previous repair operation, 69 cases had two repair operations, and 23 cases had three repair operations. The time from the last operation was 6 months to 60 months, with an average of 25 months. Postoperative complications included urinary fistula in 36 cases, urethral orifice stenosis in 52 cases and penile scar in 58 cases. The scrotal septal skin flap was used in 46 cases and scrotal fascia flap was used in 68 cases. The flaps size ranged from 1.2 cm×3.0 cm to 3.0 cm×5.5 cm. Among the 114 patients, 6 patients were complicated with urinary extravasation, which healed spontaneously in 2-4 weeks; 2 patients developed urinary fistula due to blood supply disorder at the distal end of the scrotal flap, which was repaired half a year later. Other patients healed well. 94 patients were followed up for 6-84 months, with an average of 37 months. All patients had no chordee, smooth urination, no urethral stricture and fistula. All patients were satisfied with the appearance of the penis. Urethral ultrasound and magnetic resonance hydrography were performed in 18 patients. The results showed that the reconstructed urethra was smooth, the mucosa graft had good extension, and there was no residual urine in the urethra.Conclusions:Oral mucosa prefabricated urethra could be used for repair hypospadias in adult patients who failed in repair surgeries, and could obtain good clinical effect.
