Objective To evaluate the role of mierosurgery in surgical treatment to urethrocutaneous fistula after urethroplasty in hypospadias and improve surgical results.Methods From 1999 to 2006,44 urethrocutaneous fistulae (more than 3mm in diameter) after urethroplasty for hypospadias in 33 patients were repaired with different skin flaps.For example,Thiersch technique,urthroplasty,etc.Microsurgical tech- nique was employed in every case.Results The success rates of different procedure were 84.8% (28/33) for Thiersch technique,100% (11/11) for urethroplasty respectively.The total success rate was 88.6%(39/ 44).Conclusion It's just application of skin flap for repairing of big or complex urinary fistula after hypos- padias surgery.The application of microsurgical technique can increase success rate.It is necessary to excise scar and partial urethra for hypospadias fistula combined with urethral structures,cicatricial eontracture and in- curvation of penis.Rich blood-supply,low tension and atraumatic technique are all very important to improve surgery success rates of urinary,fistula after hypospadias repair.

OBJECTIVESTo investigate the tissue ultrastructure changes of small testis and sex hormone and their correlation.

METHODSThe patients were divided into small tests (n = 8) and control group(n = 12). FSH, LH, T were determined by radioimmunassay. Diameter and wall thickness of convoluted seminiferous tubule were investigated with light microscope and electro microscopy on small testis tissue morphology and ultrastructure.

RESULTSFSH, LH, T of small testis and control group were (21.05 +/- 9.15) IU/L vs (6.74 +/- 3.52) IU/L, (22.88 +/- 6.25) IU/L vs (6.60 +/- 1.48) IU/L and (0.30 +/- 0.04) nmol/L vs (17.55 +/- 9.25) nmol/L, respectively. Seminiferous tubule diameter and wall thickness were(37.33 +/- 6.80) microns vs (198.46 +/- 29.84) microns and (10.30 +/- 1.82) microns vs (2.95 +/- 0.20) microns. Small testis tissue ultrastructure changed significantly.

CONCLUSIONSPathologic changes of small testis tissue in many parts such as seminiferous tubule, germinal epithelium, Sertoli cell, Leydig cell, limiting membrance and blood vessel may relate with genetics and immunoreaction.

Adult ; Follicle Stimulating Hormone ; metabolism ; Gonadal Steroid Hormones ; metabolism ; Humans ; Luteinizing Hormone ; metabolism ; Male ; Statistics as Topic ; Testis ; anatomy & histology ; metabolism ; ultrastructure ; Testosterone ; metabolism

OBJECTIVETo reconstruct a penis with sensation and erectile function maintained by corpora cavernosa lengthening and skin flap transferring in the penis defect cases.

METHODSThe procedure was based on the use of releasing the suspensory ligaments and part of crus, various flaps were designed as coverage material. Penis residual stump was advanced to anterior portion of the newly reconstruction penile body as "glans".

RESULTS40 patients with penis defect have been operated by the above methods. In the cases, length of the penis varied from 0.5-4.0 cm in the flaccid, 1.5-5.0 cm in erect state before operation. And after operation, it turned to 5.0-8.5 cm in the flaccid, 7.0-12.5 cm in erect state. Most of the patients recovered gross tactile sensation and had satisfactory erectile function.

CONCLUSIONWith this method, the reconstructed penis tends to have a better appearance and function. It's a more optimal method compared with the conventional operation.

Adult ; Humans ; Male ; Penile Erection ; Penis ; injuries ; innervation ; surgery ; Reconstructive Surgical Procedures ; methods ; Sensation

OBJECTIVETo summarize the experience of repair and reconstruction of penile defects as a result of devastating deep burn.

METHODSTwenty-four patients with penile defects in early or late (a half year after wound healed, the same below) stage after burn were involved. Their suspensory ligaments of penis were dissected to lengthen the penis after escharotomy with the necrotic distal part removed. The wounds formed after lengthening were covered with lower abdominal skin flap, scrotal or internal pudendal artery flap. Ten patients underwent surgery within 30 days after burn; the other 14 patients underwent surgery in the late stage. The condition of flaps and complications after surgery were observed. The lengths of penis of patients in flaccid and erection state were measured before surgery and at follow-up period. The sensory function of penile skin, the erectile function of the penis, and sexual intercourse activity of patients were followed up.

RESULTSAll the flaps survived except two, in whom areas of 1.0 cm x 0.5 cm and 1.5 cm x 1.0 cm of necrosis at distal parts were found, and they healed after dressing changes. Patients were followed up for 2 to 5 years. The length of penis in flaccid state was (7.4 +/- 1.6) cm, which was (5.3 +/- 1.4) cm longer than that before surgery (P < 0.01). The length of penis in erection state was (9.7 +/- 1.2) cm. The sensory function of penis recovered gradually about half year after surgery with well preserved erectile function. Except one who did not try to have sexual intercourse again, all the other married patients and their spouses were satisfied or quite satisfied with sexual intercourse activity.

CONCLUSIONSPenis elongation combined with skin flap grafting is a good method for the treatment of penile defects due to devastating deep burn. Suitable length and erectile function of penis can be preserved with this method.

Adolescent ; Adult ; Burns ; surgery ; Child ; Graft Survival ; Humans ; Male ; Middle Aged ; Penis ; injuries ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; Young Adult

OBJECTIVETo investigate the application of penile cavernous bodies elongation combined with fat flap for the treatment of micro-penis.

METHODSAnatomic study was performed to study the thickness of penile suspension ligaments and the relationship between the penile erection stability and the mobilization of cavernous bodies crus. The suspension ligaments were divided and cavernous bodies crus were partially mobilized, so as to release part of the cavernous bodies from inferior ramus of pubis. Then the penis was elongated sufficiently. Local fat flap was transposed to fill the front space of pubis to make sure the effective elongation of penis.

RESULTS205 cases of micro-penis were treated. The average length of the penis was 4.26 cm in the static state, 8.13 cm in erectile state before operation. After operation, it increased to 8.63 cm in the static state, 12.11 cm in erectile state.

CONCLUSIONSThe cavernous bodies can be elongated 1-2 cm more with the modified method, while the stability of penile erection is not affected.

Adolescent ; Adult ; Aged ; Humans ; Male ; Middle Aged ; Penis ; anatomy & histology ; surgery ; Surgical Flaps ; Treatment Outcome ; Young Adult

OBJECTIVETo explore a simply, effective dynamical method to correct late facial palsy.

METHODSThe method of suspending of M. temporalis, temporal fascia was reformed below: (1) To prolong flap of M. temporalis, temporal fascia by parietal periosteum. (2) To elevate the reversal level of compound flap. (3) To fill depressed temporal area by silica gel piece.

RESULTSThe compound flap is united structurally and long enough to transfer. Temporal defect is recontoured. And zygomatic area is no longer protruded.

CONCLUSIONSThe reformative method resists defect of the old one and obtains a dynamical result.

Adult ; Facial Paralysis ; surgery ; Fascia ; transplantation ; Female ; Humans ; Male ; Skull ; transplantation ; Surgical Flaps ; Temporal Muscle ; transplantation ; Young Adult

OBJECTIVETo explore the effects of the combined method of abdominal axial flap transposition and penile elongation for the treatment of the remnant penis.

METHODSFifty-two cases of the remnant penis treated with the combined method from 1984 April to February 2004 were analyzed retrospectively. Follow-up ranged from 0.5 to 20 years postoperatively.

RESULTSThe lengths (both in normal and erectile conditions) and the circumferences of the penis gained after operation were (5.6 +/- 1.4) cm, (6.8 +/- 2.5 cm and (6.9 +/- 2.3) cm respectively. The recovery rates of the sensory function were 94.2% and 100% in the glans (immediately and 3 months after operation) and 32.7%, 51.9% and 75% in the flap area (3, 6 and 12 months postoperatively). The two-point distinguishing sense in the glans and the flap area was (5.1 +/- 0.9) mm and(7.9 +/- 1.3) mm 5 years after operation. Early complications included distant flap necrosis (3 cases), disruption of the wound (2 cases), part necrosis of the skin graft in the abdominal wall (2 cases) and poor contours occurred in 4 cases in the later period because of the thickness of the flaps. All of them were corrected with satisfactory results.

CONCLUSIONThe combined method of abdominal axial flap transposition and penile elongation was recommendable for the treatment of the remnant penis because of its positive effects and less complications.

Adolescent ; Adult ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Penis ; injuries ; surgery ; Reconstructive Surgical Procedures ; Retrospective Studies ; Surgical Flaps