Application of combined penile and scrotum skin flap in reoperation for failed hypospadias repair
10.3760/cma.j.issn.2095-428X.2016.23.012
- VernacularTitle:阴茎阴囊组合皮瓣在尿道下裂再次手术中的应用
- Author:
Guodong LI
;
Zhaofang WEI
;
Jiabo CHEN
- Keywords:
Hypospadias;
Urethroplasty;
Reoperation
- From:
Chinese Journal of Applied Clinical Pediatrics
2016;31(23):1806-1808
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the application of combined penile and scrotum skin flap in the reoperation process for operation failure cases with hypospadias.Methods A retrospective analysis was performed with the inclu-sion of 1 5 failure cases with hypospadias who received combined penile and scrotal skin flap treatment for reoperation from January 201 3 to December 201 5 in the First Affiliated Hospital of Guangxi Medical University.These cases aged from 7 to 1 5 years old,with a median age of 1 0.2 years old.Among them,a 3 rd operation was performed in 4 cases,4th operation in 5 cases,5 th operation in 4 cases,and 6 th operation in 2 cases.The procedure of Onlay island flap urethro-plasty +tubularized incised plate (Onlay +TIP)urethroplasty was performed in 4 patients,and the other 1 1 cases were treated with urethral mouth basal vascular skin tube urethroplasty (Mathieu)+TIP urethroplasty.F8 or F1 0 silicone balloon catheter were used as stent in new urethra,outer dressing after operation was replaced every 2 to 3 d,the outer dressing was demolished 6 -8 d after operation.Results All patients were followed up after surgery until March 20, 201 6,the follow -up time was 4 -26 months.In these 1 5 patients,the success rate of operation was 86.7%(1 3 /1 5 ca-ses),among them,3 cases were success and 1 case was failed in Onlay +TIP group,and 1 0 cases were success and 1 case was failed in Mathieu +TIP group.The patients with successful operation were with beautiful appearance of the pe-nis,normal position of the meatus urinarius and normal urination.No peristome of urethra,urethrovaginal fistula or ure-thral diverticulum was found after surgery.However,urethral cracking of the glans of penis appeared in 2 operation failed patients,and the orificium urethrae externum was low -set,and urethroplasty was needed 1 year postoperatively. Conclusions For some failure cases with hypospadias showing suitable anatomy conditions,Onlay +TIP or Mathieu +TIP combined with penile and scrotal flap may be a good choice for the completion of reoperation.
