Multiple dorsal midline plication (MDMP) for correction of Donnahoo type Ⅲ chordee in postpubertal patient
10.3760/cma.j.issn.1000-6702.2018.01.010
- VernacularTitle:海绵体背侧中线多点折叠法矫治青春期后Donnahoo Ⅲ型阴茎下曲的疗效
- Author:
Xuejun WANG
1
;
Yu MAO
;
Shaoji CHEN
;
Yunman TANG
;
Daorui QIN
;
Mao LIU
;
Yuejiao CHEN
Author Information
1. 四川省医学科学院四川省人民医院小儿外科
- Keywords:
Hypospadias;
Donnahoo type Ⅲ;
Chordee
- From:
Chinese Journal of Urology
2018;39(1):42-44
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the role of multiple dorsal midline plication (MDMP) procedure in correction of Donnahoo type Ⅲ chordee in postpubertal patient.Methods From September 2010 to July 2013,33 postpubertal patients with Donnahoo type Ⅲ chordee (＞ 20°) were treated with MDMP procedure.The age ranged from 18 to 37 years with an average of 29 years.Primary surgery was indicated in 18 patients including type Ⅲ chordee in 11 and type Ⅲ/Ⅳ in 7,with associated hypospadias in 12.Redo surgery was warranted in 15 patients including type Ⅲ chordee in 13 and type Ⅲ/Ⅳ in 2,with associated urethral defects necessitating repair in 12.Intraoperative artificial erection was induced to confirm the degree and length of chordee.Longitudinal plication sutures,4 dots each,were applied close to the midline in a parallel fashion on each apex of curvature,to achieve satisfactory orthoplasty with 16-dot to 64-dot plication according to the chordee status,and the urethral repair indicated was achieved simultaneously.Results Satisfactory orthoplasty was achieved with 16-dot plication in 16 patients,24-dot in 10,32-dot in 6,and 64-dot in 1 patient whose penile curvature was severe and long.Followup was obtained from 35 to 69 months with an average of 46 months.Three patients lost of followup.Urethroplasty-related complications were noted in 5 patients including urethrocutaneous fistula in 2,urethral dehiscence in 1,urethral diverticulum in 1,and urethral stricture in 1.Mild cicatrical curvature (less than 15 degree) was noted in 2 patients.No postoperative priapism,erectile dysfunction,and paraesthesia was noted,nor chordee recurrence.Conclusions When applied appropriately,MDMP is an effective procedure in correction of Donnahoo type Ⅲ chordee in postpubertal patient with good and long-standing orthoplasty.
