OBJECTIVETo discuss the methods for urethral external meatus and glanuloplasty after correction of hypospadias.

METHODSThe V shape flap on the dorsal side of glan, combined with the bilateral glan flaps were moved to the ventral side. The flap at the ventral side of urethral external meatus was turned over. Then the urethral external meatus was repositioned to the top end of glan with the ventral defects covered by the dorsal flaps. Then the coniform glan was reconstructed.

RESULTSFrom January 2008 to December 2013, 28 cases were treated, including glandular hypospadias, postoperative retraction of external urethral meatus and meatal stenosis. 21 patients were followed up for 1 -12 months (average, 1 month) with marked improvement of glan appearance and retraction of external meatus. No meatal stenosis happened.

CONCLUSIONSPostoperative retraction of urethral external meatus and meatal stenosis can be corrected by V shape flap on the dorsal side of glan combined with the bilateral glan flaps. The flat appearance of glan can be improved. It is an ideal method for glandular hypospadias.

Humans ; Hypospadias ; surgery ; Male ; Penis ; surgery ; Postoperative Complications ; surgery ; Postoperative Period ; Surgical Flaps ; Urethra ; surgery ; Urethral Stricture ; etiology ; surgery

Objective:To observe the effect of Ba Duan Jin(Eight-brocade Exercise)plus Tuina(Chinese therapeutic massage)in treating primary dysmenorrhea due to cold-induced blood stasis in female college students and on the score of fatigue scale-14(FS-14). Methods:Seventy-two female college students with primary dysmenorrhea due to cold-induced blood stasis were randomized into a Tuina group and a joint group,with 36 cases in each group.The Tuina group only received Tuina manipulations.In the joint group,besides the same Tuina manipulations,patients practiced Ba Duan Jin.For both groups,the once-daily intervention was conducted from 6 d before the menstrual period until menstrual day 1 for 3 menstrual cycles.Changes in the scores of COX menstrual symptom scale(CMSS),visual analog scale(VAS),and FS-14 after the intervention were observed.Clinical efficacy was also estimated. Results:During the process,1 case dropped out in the Tuina group,and 35 cases completed the intervention;2 cases dropped out in the joint group,and 34 cases completed the intervention.The total effective rate was 94.1%in the joint group,higher than 88.6%in the Tuina group(P<0.05).After treatment,the symptom duration and intensity scores in the scores of CMSS,VAS,and FS-14 declined in both groups(P<0.05 or P<0.01);the CMSS symptom duration score and FS-14 score were lower in the joint group than in the Tuina group(P<0.05). Conclusion:Tuina manipulations alone or combined with Ba Duan Jin practice can effectively treat primary dysmenorrhea due to cold-induced blood stasis in female college students;when combined with Ba Duan Jin practice,Tuina manipulations can more significantly improve pain duration and fatigue,suggesting the advantages of combining Tuina Gongfa and manipulations.

Objective: To evaluate the feasibility of buccal musoca grafting in the treatment of longer anterior urethral stricture. Methods: From January 2012 to December 2017, 42 cases of anterior urethral stricture were treated in staged procedure. Stage 1 included the excision of the narrow urethra and the reconstruction of the urethra by transplanting buccal mucosa sheet or tube. In Stage 2, patients underwent operation including urethra anastomosis and transfer the scrotal flap for coverage, and perform suprapubic puncture cystostomy at the same time. Results: Thirty-eight of 42 cases were followed up for 5-12 months with an average of 8 months. In the followed-up 38 cases, 35 of them obtained satisfactory result. Complications occurred in 2 patients, all of them suffered from urethra restricture. One patient′s urethra stricture was located in the anastomosis, stricture length was 0.5 cm. This patient received excision of the narrow urethra and anastomosis. Stricture in another patient was located in the external urethral meatus, this patient received expansion of the external urethral meatus. With proper treatment, all of them were recovered. One patient was not satisfied with the appearence of penis postoperatively. Of all these patients, no urethral fistula or penile curvature was observed. Urination and ejaculation were normal. Conclusions A successful treatment of long anterior urethral stricture can be achieved with the excision of affected urethra, reconstruction of defect urethra with buccal mucosa flap in staged procedure, and covering the new urethra by transferring the scrotal flap.

Objective: To sum up the clinical manifestations and the method for repairing of secondary deformities of postoperation of hypospadias. Methods: Applying balanus tissue flaps and urethral meatus plastic could correct the flat balanus and prevent urethral meatus from falling back. Resecting scar completely in penis and rebuilding urethral tissues could treat secondary curved penis. Applying modified penile augmentation which involved girth enhancement by a free dermal-fat graft and penile elongation (suprapubic skin advancement-ligamentolysis) could correct shorter and much smaller penis. Results: Among January 1st 2007 to December 31st 2016, 62 cases were treated.All of them were male. Their ages were from 14 to 34 years old.55 cases were followed up from 6 months to 9 years after operations, but 7 cases could not be followed up because of the change of addresses and phone numbers.All patients achieved excellent cosmetic result. None of them had complications like urethral fistula. Conclusions After operations of hypospadias, the secondary deformities may happen when the children grow up.And these deformities always need to be corrected with operations. Balanoplasty, correction of penis and the penile augmentation are good methods for secondary deformities.Consequently, a good penis appearance and function can be acquired.

Objective:To investigate the clinical manifestation and the plastic surgery principles of perineal scar contracture deformity.Methods:Patients with perineal deformities admitted to Plastic Surgery Hospital, Chinese Academy of Medical Sciences, were enrolled from January 1, 2010 to December 31, 2018. For the purpose of scar release, wound coverage, and organ defect reconstruction, we applied multiple plastic surgery methods such as tissue expansion techniques, penile lengthening, penile reconstruction, and anoplasty.Patients were followed-up for at least 6 months after operations. Urinary function, defecation function, range of joint motion, the appearance of perineum and the scar of the operation site were evaluated.Results:16 cases, aged 13 to 44 years old, were enrolled in our study and were successfully followed up for 1 to 10 years. There were no postoperative complications in 12 patients, and poor survival of partial flaps was shown in 4 patients, and the wound healed after dress-changing. Satisfactory results were obtained as self-maintenance, self-controllable urination, and defecation were restored.Conclusions:Following principles of subarea reconstruction in plastic surgery and using multiple plastic surgery methods, satisfactory results can be obtained in the repair of perineal scar contracture, which highly improves the life qualities of patients.

Objective:To investigate the clinical manifestation and the plastic surgery principles of perineal scar contracture deformity.Methods:Patients with perineal deformities admitted to Plastic Surgery Hospital, Chinese Academy of Medical Sciences, were enrolled from January 1, 2010 to December 31, 2018. For the purpose of scar release, wound coverage, and organ defect reconstruction, we applied multiple plastic surgery methods such as tissue expansion techniques, penile lengthening, penile reconstruction, and anoplasty.Patients were followed-up for at least 6 months after operations. Urinary function, defecation function, range of joint motion, the appearance of perineum and the scar of the operation site were evaluated.Results:16 cases, aged 13 to 44 years old, were enrolled in our study and were successfully followed up for 1 to 10 years. There were no postoperative complications in 12 patients, and poor survival of partial flaps was shown in 4 patients, and the wound healed after dress-changing. Satisfactory results were obtained as self-maintenance, self-controllable urination, and defecation were restored.Conclusions:Following principles of subarea reconstruction in plastic surgery and using multiple plastic surgery methods, satisfactory results can be obtained in the repair of perineal scar contracture, which highly improves the life qualities of patients.