Modified foreskin island flap urethroplasty

Modified foreskin island flap urethroplasty for the treatment of hypospadias. Hypospadias is a congenital malformation more common in pediatric genitourinary system. At the 5th week of the embryo, the tissues on both sides of the front of the cloaca are forwarded, producing two reproductive nodules. The reproductive nodules grow rapidly, and the urogenital sinus elongates, forming a longitudinal line on the ventral side of the reproductive nodules. The long groove, the urethral groove, closes from the posterior to the uterus as the fetus develops. In the development process, there are obstacles, and the urethral groove can not be completely closed to the tip of the penis head, which causes partial cracking and formation of hypospadias. Treatment of diseases: hypospadias in children Indication Modified foreskin island flap urethroplasty is indicated for children with congenital hypospadias. Preoperative preparation 1. On the 1st day before surgery, the skin of the field was disinfected with 1:500 benzalkonium solution or 75% ethanol. The urethra was infused with 1:2000 benzalkonium solution 2 to 3 ml to disinfect the urethra. 2. Prepare blood 200 ~ 400ml. 3. Apply antibiotics. 4. Clean the enema. Surgical procedure 1. Incision: The foreskin is cut along the annular groove and the outer urethra is removed. 2. The method of forming the pedicle flap is also the same as the foreskin island flap urethroplasty, except that the urethra formed by the foreskin flap is transferred from the dorsal side to the ventral side, not through the side of the penis, but at the base of the pedicle. In the middle of the avascular area, you can do everything. 3. A central passage from the center of the ventral side of the coronary sulcus to the proximal end of the glans. The urethral opening was fixed with the penis white membrane by 2 needles, and then the pedicled percutaneous tube was fitted to the opposite end of the urethra, and the suture was sutured with 4-0 flat suture. The distal end of the foreskin tube is sutured with a 5-0 chrome gut or a synthetic absorbable suture through a tunnel and a proximal end of the apex, so that the urethra is opened to the glans. complication 1. Bleeding: After the urethral sponge or the penis leucorrhea is cut, if the suture is not sutured, hemorrhage may occur when the penis is erected. When the hemostasis is not effective, the wound must be opened to remove the hematoma and suture to stop bleeding. 2. Infection: In particular, infections are more likely to occur on the basis of bleeding and hematoma. 3. Necrosis: When the tension of the suture is too large, it may cause cracking and partial necrosis. Therefore, if the tension is too large after suturing, the dorsal incision should be made.

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