Treatment of crippled hypospadias by staged operation with oral mucosa preimplantation urethral plate
10.3760/cma.j.cn114453-20230718-00008
- VernacularTitle:口腔黏膜预植尿道板分期治疗残废型尿道下裂
- Author:
Yuan DING
1
;
Yue WANG
;
Shengli GU
Author Information
1. 遵义市第一人民医院（遵义医科大学第三附属医院）小儿外科，遵义 563000
- Keywords:
Hypospadias;
Mouth mucosa;
Preimplantation;
Surgical flaps
- From:
Chinese Journal of Plastic Surgery
2024;40(2):151-155
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of staged operations with oral mucosa preimplantation urethral plate in the treatment of crippled hypospadias.Methods:The clinical records of patients with crippled hypospadias which were treated in the First People’s Hospital of Zunyi from March 2019 to March 2023 were retrospectively reviewed. Staged operations with oral mucosa preimplantation urethral plate were applied to all patients. The survival condition of preimplantation urethral plate, urethrocutaneous fistula, urethral dehiscence, urethral diverticulum, urethrostenosis, residual chordee, the appearance of penis and urinating condition were observed.Results:Twelve male children were enrolled, ranging in age from 5 years and 1 month to 14 years, with a median age of 8 years and 2 months. All of these patients had 2 to 4 times of urethroplasty surgeries with an average time of 3.2. All patients suffered from moderate to severe chordee and lack of prepuce, including 5 patients with urethral dehiscence, 3 cases with multiple urethrocutaneous fistulas and 4 cases with urethrostenosis. All patients were followed 6 to 36 months after surgery with an average of 25 months. One patient suffered from infection of preimplantation urethral plate after the first stage operation was cured by hyperbaric oxygen therapy and local dressing. Two patients complained of urethrocutaneous fistula after the second stage operation were cured by fistulectomy. No urethral dehiscence, urethral diverticulum, urethrostenosis or residual chordee was observed in other patients. Penile appearance was not bloated and the longitudinal slit urethral orifice was located in the head of the penis. Urination was smooth and the urine line was continuous.Conclusion:Staged operation with oral mucosa preimplantation urethral plate is an effective and safe method for the treatment of crippled hypospadias.
