TIP术和OIF术在尿道下裂治疗的应用进展
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摘要
目的:总结尿道板纵切卷管法(TIP)与加盖岛状皮瓣法(OIF)尿道成形术治疗尿道下裂的疗效,并对其进行比较,探讨术式选择的条件。
方法:回顾性总结42例TIP术和26例OIF术治疗尿道下裂的临床资料,TIP术组年龄2-13岁,平均4.76岁。其中Ⅱ型3例,Ⅳ型1例。38例为初次行尿道成形术者,4例为初次尿道成形术失败,再次行尿道成形术者;OIF术组年龄2-10岁,平均4.72岁,其中Ⅱ型23例,Ⅲ型3例,均为初次行尿道成形术者。
结果: TIP术:平均手术时间80 min,有尿瘘7例,阴茎头裂开1例,无尿道狭窄,但有尿道外口狭窄1例,3例再次尿道成形术者未发生并发症;OIF术:平均手术时间115min ,有尿瘘5例,阴茎头裂开l例,无尿道狭窄。两种手术方法的尿瘘、尿道狭窄、阴茎头裂开、一次手术成功率,差异无统计学意义(p〉0.05),但两组平均手术时间,差异有统计学意义(p〈0.05)。
结论: TIP与OIF尿道成形术可用于阴茎头冠状沟、阴茎体、阴茎阴囊型尿道下裂的治疗, TIP术操作简单,且更适用于初次手术失败、需再次行尿道成形术的病例。对于阴茎发育差.尿道板条件不好的初次手术病例,仍以选择OIF术为宜。
Objective: To evaluate and compare the efficacy of the tubularized incised plate (TIP) urethroplasty and the Onlay island flap (OIF) urethroplasty in hypospadias repair, and approach the choice between the two.
Methods: The clinical data of 42 cases of TIP procedures and 26 cases of OIF procedures were analyzed Retrospectively.TIP group were 2-13 years old,with an average age of 4.76,includingⅡtype 3 cases, IV type 1 case,38 were primary surgery,4 were repeat surgery ;OIF group were 2-10 years old, with an average ageof 4.72,includingⅡtype 23 cases,and III type 3 cases,all were primary surgery.
Results: In TIP group,80 min with mean duration of surgery, 7cases with urethral fistula, 1 case with neourethral dehiscence,none with urethral stricture ,and 1 case with outside of urethral stricture,3 repeat surgery cases without complications ;In OIF group,115 min with mean duration of surgery,5 cases with urethral fistula,1case with neourethral dehiscence,and none with urethral stricture.There was no statistically significant difference in the incidence of fistula、stricture、dehiscence and success rate of onestage operation between the TIP group and the OIF group (p〉0.05),But there was statistically significant difference in the mean duration of surgery between these two groups (p〈0.05).
Conclusions: TIP urethroplasty and OIF urethroplasty can be used in distal and proximal hypospadias, TIP urethroplasty is more simplified than OIF urethroplasty, and more applicable to the primary surgery failed cases;OIF urethroplasty is suitable for the primary surgery patients with poor development of penis and urethral plate.
方法:回顾性总结42例TIP术和26例OIF术治疗尿道下裂的临床资料,TIP术组年龄2-13岁,平均4.76岁。其中Ⅱ型3例,Ⅳ型1例。38例为初次行尿道成形术者,4例为初次尿道成形术失败,再次行尿道成形术者;OIF术组年龄2-10岁,平均4.72岁,其中Ⅱ型23例,Ⅲ型3例,均为初次行尿道成形术者。
结果: TIP术:平均手术时间80 min,有尿瘘7例,阴茎头裂开1例,无尿道狭窄,但有尿道外口狭窄1例,3例再次尿道成形术者未发生并发症;OIF术:平均手术时间115min ,有尿瘘5例,阴茎头裂开l例,无尿道狭窄。两种手术方法的尿瘘、尿道狭窄、阴茎头裂开、一次手术成功率,差异无统计学意义(p〉0.05),但两组平均手术时间,差异有统计学意义(p〈0.05)。
结论: TIP与OIF尿道成形术可用于阴茎头冠状沟、阴茎体、阴茎阴囊型尿道下裂的治疗, TIP术操作简单,且更适用于初次手术失败、需再次行尿道成形术的病例。对于阴茎发育差.尿道板条件不好的初次手术病例,仍以选择OIF术为宜。
Objective: To evaluate and compare the efficacy of the tubularized incised plate (TIP) urethroplasty and the Onlay island flap (OIF) urethroplasty in hypospadias repair, and approach the choice between the two.
Methods: The clinical data of 42 cases of TIP procedures and 26 cases of OIF procedures were analyzed Retrospectively.TIP group were 2-13 years old,with an average age of 4.76,includingⅡtype 3 cases, IV type 1 case,38 were primary surgery,4 were repeat surgery ;OIF group were 2-10 years old, with an average ageof 4.72,includingⅡtype 23 cases,and III type 3 cases,all were primary surgery.
Results: In TIP group,80 min with mean duration of surgery, 7cases with urethral fistula, 1 case with neourethral dehiscence,none with urethral stricture ,and 1 case with outside of urethral stricture,3 repeat surgery cases without complications ;In OIF group,115 min with mean duration of surgery,5 cases with urethral fistula,1case with neourethral dehiscence,and none with urethral stricture.There was no statistically significant difference in the incidence of fistula、stricture、dehiscence and success rate of onestage operation between the TIP group and the OIF group (p〉0.05),But there was statistically significant difference in the mean duration of surgery between these two groups (p〈0.05).
Conclusions: TIP urethroplasty and OIF urethroplasty can be used in distal and proximal hypospadias, TIP urethroplasty is more simplified than OIF urethroplasty, and more applicable to the primary surgery failed cases;OIF urethroplasty is suitable for the primary surgery patients with poor development of penis and urethral plate.
引文
1 Baskin LS, Erol A, Li YW, et al: Anatomical studies of hypospadias[J]. J Urol, 1998,160:1108–1115.
2 Snodgrass W, Patterson K, Plaire JC, et al: Histology of the urethral plate: Implications for hypospadias repair[J]. J Urol, 2000,164:988–990.
3 Elder J S. Duckett J W.Snyder H M.Onlay isJand flap in the repair of mid and distal penile hypospadias without chordee[J].J Urol,1987,138(2):376—379.
4 Snodgrass W: Tubularized, incised plate urethroplasty for distal hypospadias[J]. J Urol,1994,151:464–465.
5 Snodgrass W, Koyle M, Manzoni G, et al: Tubularized incised plate hypospadias repair for proximal hypospadias[J]. J Urol,1998,159:2129–2131.
6 Decter RM, Franzoni DF. Didias hypospadias repair by modified Thiersch-Duplay t- echnique with or without hinging of the urethralplate:a near ideal way to correct distal hypospadias[J].J Urol,1999,162:1 156-1158.
7 Joseph G, Borer J K.Tubularized incised plate urethraplasty :expand use in primary and repeat surgery for hypospadias[J].J Urol,2001,165(3):581-583.
8 NguyenM T,S nodgrass W T. Tubularized incised plate hypospadias reoperation[J]. J Urol,2004,1 71:2404-2406.
9 Bleustein CB,Esposito MP,Soslow RA,et al.Mechanism of Healing following the Snodgrass repair[J].J Urol,2001,165(1):277-279.
10SnodgrassWT,LorenzoA.Tubularized incised plate urethroplasty for proximal hypospadias[J].BJU Int,2002,89(1):90-93.
11Stehr M, Lehner M, Schuster T, et al: Tubularized incised plate (TIP) urethroplasty (Snodgrass) in primary hypospadias repair[J]. Eur J Pediatr Surg, 2005, Dec;15(6):420-4.
12PiróBiosca C, Martín Osorio JA, Acosta Fari?a D, et al: Treatment of proximalhypospadias: the onlay technique[J]. Cir Pediatr,2004 ,Jan;17(1):25-7.
13Baskin LS, Duckett JW: Mucosal grafts in hypospadias and stricture management[J]. AUA Update Series, 1994;13:270–275.
14Elicevik M,Sander S: Tubularized Incised Plate Urethroplasty: 5 Years' Experience[J].European urology, 2004,46(5)655-659.
[1] Upadhyay J ,Shekarriz B ,Khoury AE.Midshaft hypospadias[J].uorl Clin North Am,2002,29(2):2 99-310.
[2]周家杰.尿道下裂一期成形疗效分析[J].中华泌尿外科杂志, 1996, 17(7): 421.
[3]吴文斌.略谈尿道下裂治疗现状[J].中华泌尿外科杂志,1986, 7(4):195.
[4] Feror F,Zaceara A ,Spagnoli A ,et a l.Skin graft for 2-stage treatmentof severe hypospadias;back to the future [J]? J Uorl,2002,168(4 Pt 2) : 1730-1733.
[5] Greenfield SP.T wo-stage repair for proximal hypospadias;a reappraisal [J ] . Curr Uorl Rep,2003,4(2):151-155.
[6] Geshbaum MD.Stock JA.Hanna MK.A case for2- stage repair of Perinenscortal hypospadias with severe chordee[J ] .J Uorl,2002,168(4 Pt 2 ) ;1727-1728.
[7]Duckett JW. MAGPI (meatoplasty and glanuloplasty): a procedure for subcoronal hypospadias[J]. Urol Clin North Am, 1981,8(3): 513.
[8]李衷初,葛人铃,刘国华.尿道口前移阴茎头成形术(MAGPI)治疗阴茎头型或冠状沟型的尿道下裂[J].中华小儿外科杂志. 1990, 11(4): 197.
[9]张涤生,黄文义,徐春阳.前尿道延伸术一期修复尿道下裂[J].中华外科杂志,1983, 21(6): 362.
[10]翟成琦,周德贵,赵成辉,等.尿道前移治疗尿道下裂[J].中华小儿外科杂志, 1998,19(5): 299.
[11]梁廷巨.尿道松解术治疗阴茎下弯及冠状沟型尿道下裂[J].中华泌尿外科杂志, 1995, 16(6): 341.
[12]张潍平,黄澄如,白继武,等.重度尿道下裂的手术修复[J].中华小儿外科杂,1997,8(1): 29.
[13]黄旭元,王益鑫,周立新,等.带蒂包皮内板皮管法尿道下裂一期成形术[J].中华泌尿外科杂志,1996,17(8): 500.
[14]刘中华,周国胜,田孝华,等.带蒂包皮内板皮管法一期正位口尿道下裂修复术[J].中华泌尿外科杂志, 1995, 16(7): 444.
[15]何恢绪,刘建新,骆伟宏,等.弧形带蒂阴茎阴囊联合皮瓣重度尿道下裂一期成形术[J].中华泌尿外科杂志,1989,10(2): 99.
[16]袁继炎,周学锋,杨晓进,等.保留尿道板、外嵌带蒂岛状包皮瓣一期尿道成形术[J].中华小儿外科杂志, 1997,18(6):372.
[17]蒋先镇,何乐业,邓素雄.一期手术修复小儿尿道下裂[J].中华泌尿外科杂志,1998,19 (6): 295.
[18]Baskin LS, Duckett JW, Ueoka K, et al. Changing concepts of hypospadias curvature lead to more onlay island flap procedures[J]. J Urol, 1994,151(1): 191.
[19]李式瀛,黄金井,林子豪,等.应用阴囊纵隔血管带蒂皮瓣修复尿道下裂[J].中国医学科学院学报, 1984,6:25.
[20]梅桂色.带蒂阴囊正中皮管一期尿道成形术25例报告[J].广西医学,1999,21(3): 518.
[21]戴世希,汤凤萍,李爽,等.带蒂帽状包皮瓣尿道成形术治疗尿道下裂[J].中华泌尿外科杂志, 1998,19(11): 691.
[22]黄鲁刚,陈绍基,王明和.阴囊正中带蒂皮瓣尿道下裂修复术远期疗效[J].临床泌尿外科杂志, 1999,14(5): 216.
[23]王军,李玉魁,陈志文.阴囊纵隔双蒂岛状皮瓣修复尿道下裂[J].中华整形烧伤外科杂志,1996,12(1): 19.
[24]Snodgrass W. Tubularized incised plate urethroplasty for distal hypospadias[J].J Urol,1994, 151(2): 464.
[25]Oswald J, Korner I, Riccabona M. Comparison of the perimeatal based flap (Mathieu) and the tubularized incised plate urethroplasty (Snodgrass) in primary distal hypospadias[J]. BJU Int, 2000, 85(6): 725.
[26]Snodgrass W, Koyle M, Manzoni G, et al. Tubularized incised plate hypospadias repair for proximal hypospadias[J].J Urol, 1998, 159(6): 2129.
[27]Zaontz M. Editorial comment on Mathieu hypospadias repair: experience in 202 patients[J].J Urol, 1999, 162(12): 2142.
[28]Snodgrass W, Koyle M, Manzoni G, et al. Tubularized incised plate hypospadias repair: results of a multicenter experience[J].J Urol, 1996, 156(2pt2): 839.
[29]Bleustein CB,Esposito MP,Soslow RA,et al.Mechanism of healing following the Snodgrass repair[J].J Urol,2001,165(1): 277.
[30]Snodgrass W. Does tubularized incised plate hypospadias repair create neourethral strictures?[J]. J Urol, 1999, 162(3pt2): 1159.
[31]Sugarman ID, Trevett J, Malone PS. Tubularization of the incisedurethtal plate (Snodgrass procedure) for primary hypospadiassurgery[J]. Br J Urol, 1999, 83(1): 88.
[32]Jayanthi VR.The modified Snodgrass hypospadias repair;reducing the Risk of fistula and meatal stenosis[J ] .J Urol,2003,170(4 Pt 2 ):1603-1605.
[33]Cheng EY,Vemulapalli SN,Korpp BP.Snodgrass hypospadias repair with vascularized dartos flap;the perfect repair for virgin cases of hypospadias [J].JUorl,2002,168(4 Pt 2 ):1723-1726. [34) Funress PD,Hutcheson J .Successful hypospadias repair with entral based vascular dartos pedicle for urethral coverage[J].J Urol 2003.169(5);1825-1827.
[35] Sengezer M ,D eveci M ,O zturk S ,et a l.Two in one:patient.contorlled Epidural analgesia(PCEA) to prevent erection and control pain in adult hypospadias-surgery patients[ J] . Br J Plast Surg,2002 ,55(6):494-497.
[36]Barraza MA, Roth DR, Terry WJ, et al. One-stage reconstruction of moderately severe hypospadias[J].J Urol,1987,137(4): 714.
[37]谢家伦,刘文旭,莫家骢,等.再次尿道成形术治疗先天性尿道下裂术后严重并发症[J].中华小儿外科杂志,1998,19(6): 353.
[38]Duel BP,Barthold JS,Gonzalez R.Management of urethral strictures after hypospadias repair[J].J Urol,1998,160(1): 170.
1马腾骧.实用泌尿外科手术技巧[M].天津:天津科学技术出版社,2002:475-12.
2梅骅.泌尿外科手术学[M].北京:人民卫生出版社,2000:498-18.
3蒋先镇,何乐业,蒋志强等.不同术式一期修复男童尿道下裂[J].中华泌尿外科杂志,2005, 26(2):136.
4陆曙炎,主译.泌尿外科手术创新与改良(Rudolf Hohenfellner Innovation in Urologic Surgery)[M].上海:上海科学技术出版社,2000,286-19.
5关志忱,梅骅,主译.泌尿外科手术图谱(Frank Hinman Atlas of Urologic Surgery)[M].北京:人民卫生出版社,2005.111-22.
6丁浩,汪春兰等.尿道下裂术后多发尿瘘的显微外科修复[J].安徽医科大学学报,2007(2):228.
1 Baskin LS, Erol A, Li YW, et al: Anatomical studies of hypospadias[J]. J Urol, 1998,160:1108–1115.
2 Snodgrass W, Patterson K, Plaire JC, et al: Histology of the urethral plate: Implications for hypospadias repair[J]. J Urol, 2000,164:988–990.
3 Elder J S. Duckett J W.Snyder H M. Onlay isJand flap in the repair of mid and distal penile hypospadias without chordee[J].J Urol,1987,138(2):376—379.
4 Snodgrass W: Tubularized, incised plate urethroplasty for distal hypospadias[J]. J Urol,1994,151:464–465.
5 Joseph G, Borer J K.Tubularized incised plate urethraplasty :expand use in p- rimary and repeat surgery for hypospadias[J].J Urol.2001,165(3):581-583.
6 Bleustein CB,Esposito MP,Soslow RA,et al.Mechanism of Healing following the Snodgrass repair[J].J Urol,2001,165(1):277-279.
7 SnodgrassWT,LorenzoA.Tubularized incised plate urethroplasty for proximal hypospadias[J].BJU Int,2002,89(1):90-93.
8 Stehr M, Lehner M, Schuster T, et al: Tubularized incised plate (TIP) urethroplasty (Snodgrass) in primary hypospadias repair[J]. Eur J Pediatr Surg, 2005, Dec;15(6):420-4.
9 PiróBiosca C, Martín Osorio JA, Acosta Fari?a D, et al: Treatment of proximal hypospadias: the onlay technique[J]. Cir Pediatr,2004 ,Jan;17(1):25-7.
10Elicevik M,Sander S: Tubularized Incised Plate Urethroplasty: 5 Years' Experience[J]. European urology, 2004,46(5)655-659.
2 Snodgrass W, Patterson K, Plaire JC, et al: Histology of the urethral plate: Implications for hypospadias repair[J]. J Urol, 2000,164:988–990.
3 Elder J S. Duckett J W.Snyder H M.Onlay isJand flap in the repair of mid and distal penile hypospadias without chordee[J].J Urol,1987,138(2):376—379.
4 Snodgrass W: Tubularized, incised plate urethroplasty for distal hypospadias[J]. J Urol,1994,151:464–465.
5 Snodgrass W, Koyle M, Manzoni G, et al: Tubularized incised plate hypospadias repair for proximal hypospadias[J]. J Urol,1998,159:2129–2131.
6 Decter RM, Franzoni DF. Didias hypospadias repair by modified Thiersch-Duplay t- echnique with or without hinging of the urethralplate:a near ideal way to correct distal hypospadias[J].J Urol,1999,162:1 156-1158.
7 Joseph G, Borer J K.Tubularized incised plate urethraplasty :expand use in primary and repeat surgery for hypospadias[J].J Urol,2001,165(3):581-583.
8 NguyenM T,S nodgrass W T. Tubularized incised plate hypospadias reoperation[J]. J Urol,2004,1 71:2404-2406.
9 Bleustein CB,Esposito MP,Soslow RA,et al.Mechanism of Healing following the Snodgrass repair[J].J Urol,2001,165(1):277-279.
10SnodgrassWT,LorenzoA.Tubularized incised plate urethroplasty for proximal hypospadias[J].BJU Int,2002,89(1):90-93.
11Stehr M, Lehner M, Schuster T, et al: Tubularized incised plate (TIP) urethroplasty (Snodgrass) in primary hypospadias repair[J]. Eur J Pediatr Surg, 2005, Dec;15(6):420-4.
12PiróBiosca C, Martín Osorio JA, Acosta Fari?a D, et al: Treatment of proximalhypospadias: the onlay technique[J]. Cir Pediatr,2004 ,Jan;17(1):25-7.
13Baskin LS, Duckett JW: Mucosal grafts in hypospadias and stricture management[J]. AUA Update Series, 1994;13:270–275.
14Elicevik M,Sander S: Tubularized Incised Plate Urethroplasty: 5 Years' Experience[J].European urology, 2004,46(5)655-659.
[1] Upadhyay J ,Shekarriz B ,Khoury AE.Midshaft hypospadias[J].uorl Clin North Am,2002,29(2):2 99-310.
[2]周家杰.尿道下裂一期成形疗效分析[J].中华泌尿外科杂志, 1996, 17(7): 421.
[3]吴文斌.略谈尿道下裂治疗现状[J].中华泌尿外科杂志,1986, 7(4):195.
[4] Feror F,Zaceara A ,Spagnoli A ,et a l.Skin graft for 2-stage treatmentof severe hypospadias;back to the future [J]? J Uorl,2002,168(4 Pt 2) : 1730-1733.
[5] Greenfield SP.T wo-stage repair for proximal hypospadias;a reappraisal [J ] . Curr Uorl Rep,2003,4(2):151-155.
[6] Geshbaum MD.Stock JA.Hanna MK.A case for2- stage repair of Perinenscortal hypospadias with severe chordee[J ] .J Uorl,2002,168(4 Pt 2 ) ;1727-1728.
[7]Duckett JW. MAGPI (meatoplasty and glanuloplasty): a procedure for subcoronal hypospadias[J]. Urol Clin North Am, 1981,8(3): 513.
[8]李衷初,葛人铃,刘国华.尿道口前移阴茎头成形术(MAGPI)治疗阴茎头型或冠状沟型的尿道下裂[J].中华小儿外科杂志. 1990, 11(4): 197.
[9]张涤生,黄文义,徐春阳.前尿道延伸术一期修复尿道下裂[J].中华外科杂志,1983, 21(6): 362.
[10]翟成琦,周德贵,赵成辉,等.尿道前移治疗尿道下裂[J].中华小儿外科杂志, 1998,19(5): 299.
[11]梁廷巨.尿道松解术治疗阴茎下弯及冠状沟型尿道下裂[J].中华泌尿外科杂志, 1995, 16(6): 341.
[12]张潍平,黄澄如,白继武,等.重度尿道下裂的手术修复[J].中华小儿外科杂,1997,8(1): 29.
[13]黄旭元,王益鑫,周立新,等.带蒂包皮内板皮管法尿道下裂一期成形术[J].中华泌尿外科杂志,1996,17(8): 500.
[14]刘中华,周国胜,田孝华,等.带蒂包皮内板皮管法一期正位口尿道下裂修复术[J].中华泌尿外科杂志, 1995, 16(7): 444.
[15]何恢绪,刘建新,骆伟宏,等.弧形带蒂阴茎阴囊联合皮瓣重度尿道下裂一期成形术[J].中华泌尿外科杂志,1989,10(2): 99.
[16]袁继炎,周学锋,杨晓进,等.保留尿道板、外嵌带蒂岛状包皮瓣一期尿道成形术[J].中华小儿外科杂志, 1997,18(6):372.
[17]蒋先镇,何乐业,邓素雄.一期手术修复小儿尿道下裂[J].中华泌尿外科杂志,1998,19 (6): 295.
[18]Baskin LS, Duckett JW, Ueoka K, et al. Changing concepts of hypospadias curvature lead to more onlay island flap procedures[J]. J Urol, 1994,151(1): 191.
[19]李式瀛,黄金井,林子豪,等.应用阴囊纵隔血管带蒂皮瓣修复尿道下裂[J].中国医学科学院学报, 1984,6:25.
[20]梅桂色.带蒂阴囊正中皮管一期尿道成形术25例报告[J].广西医学,1999,21(3): 518.
[21]戴世希,汤凤萍,李爽,等.带蒂帽状包皮瓣尿道成形术治疗尿道下裂[J].中华泌尿外科杂志, 1998,19(11): 691.
[22]黄鲁刚,陈绍基,王明和.阴囊正中带蒂皮瓣尿道下裂修复术远期疗效[J].临床泌尿外科杂志, 1999,14(5): 216.
[23]王军,李玉魁,陈志文.阴囊纵隔双蒂岛状皮瓣修复尿道下裂[J].中华整形烧伤外科杂志,1996,12(1): 19.
[24]Snodgrass W. Tubularized incised plate urethroplasty for distal hypospadias[J].J Urol,1994, 151(2): 464.
[25]Oswald J, Korner I, Riccabona M. Comparison of the perimeatal based flap (Mathieu) and the tubularized incised plate urethroplasty (Snodgrass) in primary distal hypospadias[J]. BJU Int, 2000, 85(6): 725.
[26]Snodgrass W, Koyle M, Manzoni G, et al. Tubularized incised plate hypospadias repair for proximal hypospadias[J].J Urol, 1998, 159(6): 2129.
[27]Zaontz M. Editorial comment on Mathieu hypospadias repair: experience in 202 patients[J].J Urol, 1999, 162(12): 2142.
[28]Snodgrass W, Koyle M, Manzoni G, et al. Tubularized incised plate hypospadias repair: results of a multicenter experience[J].J Urol, 1996, 156(2pt2): 839.
[29]Bleustein CB,Esposito MP,Soslow RA,et al.Mechanism of healing following the Snodgrass repair[J].J Urol,2001,165(1): 277.
[30]Snodgrass W. Does tubularized incised plate hypospadias repair create neourethral strictures?[J]. J Urol, 1999, 162(3pt2): 1159.
[31]Sugarman ID, Trevett J, Malone PS. Tubularization of the incisedurethtal plate (Snodgrass procedure) for primary hypospadiassurgery[J]. Br J Urol, 1999, 83(1): 88.
[32]Jayanthi VR.The modified Snodgrass hypospadias repair;reducing the Risk of fistula and meatal stenosis[J ] .J Urol,2003,170(4 Pt 2 ):1603-1605.
[33]Cheng EY,Vemulapalli SN,Korpp BP.Snodgrass hypospadias repair with vascularized dartos flap;the perfect repair for virgin cases of hypospadias [J].JUorl,2002,168(4 Pt 2 ):1723-1726. [34) Funress PD,Hutcheson J .Successful hypospadias repair with entral based vascular dartos pedicle for urethral coverage[J].J Urol 2003.169(5);1825-1827.
[35] Sengezer M ,D eveci M ,O zturk S ,et a l.Two in one:patient.contorlled Epidural analgesia(PCEA) to prevent erection and control pain in adult hypospadias-surgery patients[ J] . Br J Plast Surg,2002 ,55(6):494-497.
[36]Barraza MA, Roth DR, Terry WJ, et al. One-stage reconstruction of moderately severe hypospadias[J].J Urol,1987,137(4): 714.
[37]谢家伦,刘文旭,莫家骢,等.再次尿道成形术治疗先天性尿道下裂术后严重并发症[J].中华小儿外科杂志,1998,19(6): 353.
[38]Duel BP,Barthold JS,Gonzalez R.Management of urethral strictures after hypospadias repair[J].J Urol,1998,160(1): 170.
1马腾骧.实用泌尿外科手术技巧[M].天津:天津科学技术出版社,2002:475-12.
2梅骅.泌尿外科手术学[M].北京:人民卫生出版社,2000:498-18.
3蒋先镇,何乐业,蒋志强等.不同术式一期修复男童尿道下裂[J].中华泌尿外科杂志,2005, 26(2):136.
4陆曙炎,主译.泌尿外科手术创新与改良(Rudolf Hohenfellner Innovation in Urologic Surgery)[M].上海:上海科学技术出版社,2000,286-19.
5关志忱,梅骅,主译.泌尿外科手术图谱(Frank Hinman Atlas of Urologic Surgery)[M].北京:人民卫生出版社,2005.111-22.
6丁浩,汪春兰等.尿道下裂术后多发尿瘘的显微外科修复[J].安徽医科大学学报,2007(2):228.
1 Baskin LS, Erol A, Li YW, et al: Anatomical studies of hypospadias[J]. J Urol, 1998,160:1108–1115.
2 Snodgrass W, Patterson K, Plaire JC, et al: Histology of the urethral plate: Implications for hypospadias repair[J]. J Urol, 2000,164:988–990.
3 Elder J S. Duckett J W.Snyder H M. Onlay isJand flap in the repair of mid and distal penile hypospadias without chordee[J].J Urol,1987,138(2):376—379.
4 Snodgrass W: Tubularized, incised plate urethroplasty for distal hypospadias[J]. J Urol,1994,151:464–465.
5 Joseph G, Borer J K.Tubularized incised plate urethraplasty :expand use in p- rimary and repeat surgery for hypospadias[J].J Urol.2001,165(3):581-583.
6 Bleustein CB,Esposito MP,Soslow RA,et al.Mechanism of Healing following the Snodgrass repair[J].J Urol,2001,165(1):277-279.
7 SnodgrassWT,LorenzoA.Tubularized incised plate urethroplasty for proximal hypospadias[J].BJU Int,2002,89(1):90-93.
8 Stehr M, Lehner M, Schuster T, et al: Tubularized incised plate (TIP) urethroplasty (Snodgrass) in primary hypospadias repair[J]. Eur J Pediatr Surg, 2005, Dec;15(6):420-4.
9 PiróBiosca C, Martín Osorio JA, Acosta Fari?a D, et al: Treatment of proximal hypospadias: the onlay technique[J]. Cir Pediatr,2004 ,Jan;17(1):25-7.
10Elicevik M,Sander S: Tubularized Incised Plate Urethroplasty: 5 Years' Experience[J]. European urology, 2004,46(5)655-659.