男孩尿道下裂手术矫治的扩张方法

N. R. Akramov, I. Kagantsov, E. I. Khaertdinov
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引用次数: 0

摘要

治疗男孩尿道下裂的困难一直持续到今天。手术矫正后尿道下裂、瘘管、狭窄、尿道憩室、尿道道缩回、龟头开裂等并发症发生。同时,很难理解各种各样的矫正尿道下裂的方法,这给专家带来了困惑,并对治疗结果产生了负面影响。文献描述了300多种不同的矫正尿道下裂的方法,但没有一种方法是完美的,也没有普遍接受的治疗标准。尽管如此,手术方式的选择取决于尿道下裂的类型,这是一个既定的事实。一个成功的尿道下裂修复技术应该完成良好的外观和功能的结果。本文综述了尿道成形术中的扩张技术。19世纪末首次出现了尿道前移术的经验,但该技术并不受欢迎,并没有取得显著的成功。然而,到20世纪末,更有效的尿道成形术扩张技术开始发展,在世界范围内得到广泛应用(Koff S.A, Ti-Seng Chang, Belman A.B, MAGPI, LUM等)。据科学文献报道,尿道前移是一种安全可靠的矫正尿道下裂的方法,被认为是一种替代神经尿道的方法。该技术具有手术时间短、无需尿道管化、功能美观效果好、并发症少等竞争优势。因此,尿道成形术的扩张技术被认为是矫正远端尿道下裂的一个很好的选择,这应该是每个儿科外科医生和泌尿科医生的军械库。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Distension methods of surgical correction of hypospadias in boys
Difficulties in the treatment of hypospadias in boys persist to this day. After surgical correction of hypospadias, fistulas, strictures, urethral diverticula, retraction of the meatus, glans dehiscence and other complications occur. At the same time, it is quite difficult to understand the whole variety of proposed methods for correcting hypospadias, which creates confusion for specialists and negatively affects the results of treatment. The literature describes more than 300 different methods of correcting hypospadias, but none of the methods is perfect, and there are no generally accepted treatment standards. Despite this, it is an established fact that the choice of the surgery procedure depends on the type of hypospadias. A successful technique of hypospadias repair should be completed with a good cosmetic and functional result. The article presents an overview of the distension techniques of urethroplasty. For the first time, the experience of urethral advancement was presented at the end of the XIX century, but the technique was unpopular and did not have significant success. However, by the end of the XX century, more effective distension techniques of urethroplasty began to be developed, which were widely used around the world (Koff S.A., Ti-Seng Chang, Belman A.B., MAGPI, LUM, etc.). According to scientific literature, urethral advancement is a safe and reliable way to correct distal hypospadias, and it is considered as an alternative to creating a neourethra. This technique has many competitive advantages, such as the short operation time, the absence of urethral tubularization, excellent functional and cosmetic results, and a small number of complications. It, therefore, follows that distension techniques of urethroplasty are considered a good option for correcting distal hypospadias, which should be in the arsenal of every pediatric surgeon and urologist.
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