RU2371104C1 - Surgery technique for hypospadias in boys - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention concerns medicine, particularly paediatric urology, and can be used for treatment of patients suffering from hypospadias. A pedicle graft is cut of hypodermic tissues of foreskin. The graft is moved onto the ventral surface of penis. Skin plasty follows. The formed graft closes the whole suturing line on the formed urethra. Further, a graft is additionally cut of hypodermic tissues of penis. Said graft is moved on the other side of penis. The cut graft is applied on the first moved graft with closing position of hypospatic meatus and a proximal part of the formed urethral tube without balanus.

EFFECT: method allows eliminating fistula formation; does not interfere with balanus plasty, eliminates cosmetic defect caused by penis rotation.

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Description

The invention relates to medicine, in particular to pediatric urology, and can be used to treat patients with hypospadias.

A known method of surgical treatment of hypospadias in boys, including the formation of the missing section of the urethral tube with its output to the top of the glans penis, followed by restoration of the skin and head of the penis (Snodgrass W .: Tubularized, incised plate urethroplastu for distal hypospadias. J. Urol., 151 (2): 464-5, Feb. 1944).

The disadvantage of this method is that the distal part of the urethra, its capitate is surrounded on all sides by the spongy body of the urethra, which creates additional resistance to the flow of urine during urination. For the same reason, there is a likelihood of developing meatostenosis, and there may be a divergence of sutures on the glans penis.

The closest technical solution for the combination of essential features is a method of surgical treatment of hypospadias in boys, including cutting a flap from the subcutaneous tissues of the foreskin on the vascular pedicle, moving it to the ventral surface around the penis and covering it with a suture line (Dorsal double-layer dartos flap for preventing fistulae in the Snodgrass technique. Urol Int. 2007; 78 (3); 241-4-Links).

The disadvantage of this method is that moving the flap around the penis can lead to rotation of the penis, which is a serious cosmetic defect.

The problem to which the invention is directed, is to increase the effectiveness of surgical treatment.

The problem is solved due to the fact that in a method for the surgical treatment of gypsopadia in boys, including cutting a flap from the subcutaneous tissues of the foreskin on the vascular pedicle and moving it to the ventral surface of the penis, they additionally cut the flap from the subcutaneous tissues of the penis and move it on the other side penis, followed by applying it to the first flap with the closure of the location of the hypospadias meatus and the proximal part of the formed urethral tube.

Figure 1-4 presents illustrations of a surgical operation for the treatment of hypospadias.

At the initial stage of the operation, an urethral tube is formed according to the Duplay method. From the subcutaneous tissues of the flesh, a flap is cut out on the feeding leg (Fig. 1).

The flap rotates around the penis, and it completely closes the entire line of sutures on the formed urethra (figure 2). From the subcutaneous tissues of the penis, an additional flap is cut out (Fig. 3). This flap closes the location of the hypospadias meatus and the proximal part of the formed urethral tube, excluding the head (figure 4).

This method eliminates the formation of fistulas on the glans penis, does not interfere with the plastic of the head, is suitable for any size of the head and for closing the formed urethra of any length.

An example of using the proposed method of surgical treatment of hypospadias.

03/28/08 in the hospital №9 named. Speransky G.N. Moscow, a sick boy of 6 years old was diagnosed with a congenital malformation of the urinary system. Hypospadias, stem form.

The patient underwent surgery. A longitudinal section of the urethral pathway was performed using the Snodgrass technique, and an enlarged area was cut out on the ventral surface of the penis, including the hypospadias meatus. The urethral tube is formed according to the Duplay principle, on the urethral catheter 8 Ball. Nodal joints PDS6. The seam line is covered with a flap on the feeding leg of the subcutaneous tissues of the foreskin and penis. Plastic surgery of the skin with circumcision of the foreskin. In the postoperative period, the patient received magnetotherapy on the penis. 04/14/08 was discharged home in satisfactory condition.

This method allows to exclude the formation of fistulas, does not interfere with the plastic of the head for any size of the head and to close the formed urethra of any length.

Claims (1)

A method of surgical treatment of hypospadias in boys, including cutting a flap from the subcutaneous tissues of the foreskin on the vascular pedicle and moving it to the ventral surface of the penis, skin plasticity, characterized in that the formed flap covers the entire line of sutures on the formed urethra, then an additional flap is cut from subcutaneous tissue of the penis, move it on the other side of the penis and apply it to the first flap with the closure of the location of the hypospadias Tusa and proximal urethral tube formed, excluding the head.

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