Covered pedicled prepuce flap urethroplasty
The pedicled pedicle urethroplasty is based on the pedicled pedicled pelvic urethroplasty designed by Duckett. The main design principle is to retain a urethral plate and then carry the pedicle skin. The flap is transferred to the ventral side of the penis to cover the urethral plate and sutured to form a new urethra. Urinary fistula and urethral stricture rarely occur in this surgical procedure. Treatment of diseases: hypospadias Indication Capped pedicle flap urethroplasty for: 1. There is no penile curvature or a slight penile curvature before the type of hypospadias. 2, the penis head is well developed. Preoperative preparation 1, the penis is too small, appropriate application of male hormone therapy, after the development of the penis, and then surgery. 2. Prophylactic use of broad-spectrum antibiotics 1d before surgery and continued until the wound healed. 3. Clean the skin of the surgical field with a small irritating soap solution. Do not use any cleaning agent that stains the skin and confuses the blood vessels. 4. After anesthesia, separate the foreskin adhesion, expose the coronary sulcus, remove the accumulated smegma, and flush the urethra with 0.5% chlorhexidine or dilute iodine to eliminate possible bacteria. Surgical procedure The 1st and 4th wires run through the top of the penis head for traction. 2, the incision shown in the dotted line in the figure, extending around the lower edge of the outer urethra of the urethra up to the tip of the penis to make a long "U" shaped incision, the width of about 0.5cm, cut the skin to the level of the anterior membranous. A circular incision is made around the coronal groove on both sides of the long "U" shaped incision, the penis skin is separated to the root of the penis, and the urethra is slightly dissociated, and the outer urethra is trimmed obliquely. According to the length of the "U"-shaped flap, a transverse pedicled sheath inner panel is cut, and the width is to be wrapped around the long "U"-shaped flap to be wrapped around the porous stent drainage tube. 3, urethra and penis head formation will be traversing the pedicle flap to the ventral side of the penis, and a long "U" shaped flap wrapped around the stent tube, sutured into a new urethra with a 5-0 absorbable line. Fully free the wings on both sides of the penis head and wrap around the new urethra. 4, repair the dry wound of the penis in the dorsal skin of the penis to make a longitudinal incision, and then wrapped around the ventral side, nylon mesh pressure dressing.
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