Tong Fangyun,Zhao Yaowang,Liu Li,et al.Treatments and efficacies of urethral deformity associated with concealed penis[J].Journal of Clinical Pediatric Surgery,,():768-771.[doi:10.3760/cma.j.cn101785-202309035-012]
Treatments and efficacies of urethral deformity associated with concealed penis
- Keywords:
- Concealed Penis; Epispadias; Hypospadias; Diagnosis; Therapy
- Abstract:
- Objective To explore the surgical treatments and efficacies of concealed penis (CP) children with urethral deformity.Methods From January 2019 to March 2023,the relevant clinical data were retrospectively reviewed for 17 CP children with urethral deformity.After intraoperative exploration and reversal,there were epispadias (n=6) and hypospadias (n=11).They underwent repair of epispadias or hypospadias and penile exposure.The complications of wound infection,fistula,stenosis and recurrence of dorsiflexion or downward curvature were recorded.Results All operations were successfully completed.One case of hypospadias had fistula after removing catheter and one case of epispadias developed wound infection and dehiscence post-operation.Re-operation was performed for urethral fistula repair and urethroplasty.Postoperative outpatient follow-up period was (6-36) month.Appearance correction and postoperative recovery were excellent and their parents were satisfied with operative outcomes.Mean urinary flow rate was (10.53±2.22) ml/s in children with epispadias and (10.45±2.88) ml/s in those with hypospadias.There was no stenosis or fistula and spontaneous urination normalized. Conclusions For CP children with epispadias or hypospadias,simultaneous repair of epispadias or hypospadias may be performed along with correcting CP.Postoperative complications are fewer and operative outcomes decent.
References:
[1] 中华医学会男科学分会.儿童隐匿性阴茎诊治的中国专家共识[J].中华男科学杂志,2021,27(10):941-947.DOI:10.13263/j.cnki.nja.2021.10.012. Branch of Andrology,Chinese Medical Association:Chinese Expert Consensus on Diagnosing and Treating Concealed Penis in Children[J].Natl J Androl,2021,27(10):941-947.DOI:10.13263/j.cnki.nja.2021.10.012.
[2] 刘进,杨嗣星,王玲珑,等.不完全型男性尿道上裂并隐匿型阴茎1例[J].中华男科学杂志,2008,14(2):179-180.DOI:10.13263/j.cnki.nja.2008.02.017. Liu J,Yang SX,Wang LL,et al.Incomplete male epispadias with concealed penis:one case report[J].Natl J Androl,2008,14(2):179-180.DOI:10.13263/j.cnki.nja.2008.02.017.
[3] Sabra TA,Abdelmohsen SM,Ali AK.Surgical correction of epispadias associated with buried penis[J].Int J Surg Case Rep,2023,108:108406.DOI:10.1016/j.ijscr.2023.108406.
[4] 尤建军,张林琳,陈玉乐,等.巨尿道口伴完整包皮型尿道下裂的治疗(附7例报告)[J].中华男科学杂志,2016,22(6):569-571.DOI:10.13263/j.cnki.nja.2016.06.019. You JJ,Zhang LL,Chen YL,et al.Treatment of megameatus intact prepuce hypospadias:a report of 7 cases[J].Natl J Androl,2016,22(6):569-571.DOI:10.13263/j.cnki.nja.2016.06.019.
[5] Bhat A,Bhat M,Bhat A,et al.Results of tubularized urethral plate urethroplasty in Megameatus Intact Prepuce[J].Indian J Urol,2017,33(4):315-318.DOI:10.4103/iju.IJU_361_16.
[6] Cendron M.The megameatus,intact prepuce variant of hypospadias:use of the inframeatal vascularized flap for surgical correction[J].Front Pediatr,2018,6:55.DOI:10.3389/fped.2018.00055.
[7] 陈家蓉,黄晶晶,石群峰,等.巨尿道口伴完整包皮型尿道下裂的手术治疗效果分析[J].广西医学,2017,39(8):1249-1250.DOI:10.11675/j.issn.0253-4304.2017.08.41. Chen JR,Huang JJ,Shi QF,et al.Surgical treatment outcomes of megameatus intact prepuce hypospadias[J].Guangxi Med J,2017,39(8):1249-1250.DOI:10.11675/j.issn.0253-4304.2017.08.41.
[8] Bhat A,Bhat M,Kumar R,et al.Functional and cosmetic outcome of partial penile disassembly repair in isolated male epispadias patients[J].Afr J Urol,2017,23(3):240-244.DOI:10.1016/j.afju.2015.09.010.
[9] Ben-David R,Kupershmidt A,Dekalo S,et al.Dorsal penile curvature and megameatus intact prepuce hypospadias:a common association in a rare variant of hypospadias[J].J Pediatr Urol,2021,17(4):517.e1-517.e4.DOI:10.1016/j.jpurol.2021.04.006.
[10] Bitaraf M,Mahdavi Sharif P,Torabinavid P,et al.Introduction of a modified single stage reconstruction technique of male penopubic epispadias[J].BMC Urol,2022,22(1):134.DOI:10.1186/s12894-022-01089-2.
[11] Fahmy MAB,Shenawy AAE,Altramsy A,et al.Penile median raphe anomalies as an indicator of megameatus intact prepuce anomaly in children undergoing routine circumcision[J].Urology,2018,121:164-167.DOI:10.1016/j.urology.2018.07.036.
[12] Duan SX,Jiang XW,Zhang X,et al.Megameatus intact prepuce treated with urethral plate-preserving surgery:a retrospective study of an unusual hypospadias variant[J].Transl Androl Urol,2019,8(6):583-590.DOI:10.21037/tau.2019.10.12.
[13] Bhat DA,Bhat DA,Khandelwal DN,et al.Modified partial penile disassembly repair for improved functional and cosmetic outcome in isolated male epispadias[J].J Plast Reconstr Aesthet Surg,2021,74(10):2637-2644.DOI:10.1016/j.bjps.2021.03.039.
Memo
收稿日期:2023-9-20。
基金项目:湖南省卫生健康委科研计划项目(B202304057979);湖南省儿童泌尿生殖疾病临床医学研究中心(2021SK4017)
通讯作者:赵夭望,Email:yw508@xinlang.com