皮肤软组织扩张技术应用于尿道下裂修复术的设想

Hypothesis of skin soft tissue expansion used in hypospadias repair

尿道下裂是男性外生殖器常见的先天性缺陷,其主要表现为尿道开口异位以及阴茎下曲畸形,手术矫正畸形是治疗尿道下裂的惟一方法。尿道下裂的修复重建有多种技巧,但是术后仍然可能发生多种并发症,很多并发症是由于修复材料的缺乏而直接或者间接导致的。阴茎自身的皮肤软组织因其天然优势而成为修复尿道下裂的最佳材料。结合尿道下裂手术治疗的现状,借鉴皮肤软组织扩张技术在整形、美容及修复等领域中的成功应用经验,我们提出将皮肤软组织扩张技术应用于尿道下裂修复术的设想。即在尿道下裂的修复前期,根据尿道下裂的类型以及修复材料的缺乏程度,在阴茎局部利用软组织扩张器扩张阴茎皮肤及软组织,从而为顺利施行尿道下裂修复手术提供充足的修复材料,改善修复术后阴茎的局部外观并减少术后并发症。该设想为尿道下裂的修复策略提供了一种新的思路。我们将在近期开展相关的动物和临床试验,期望证实该方法的有效性及安全性。

Hypospadias is one of the most common congenital anomalies of the external genitalia in males, and it is mainly manifested as ectopia of ureteral orifice and penile chordee. Operation for correction of the deformity is the only method of hypospadias treatment. A variety of operative techniques are applied to the hypospadias repair, but many complications may occur after the hypospadias surgery. Many complications appear as a result of the shortage of repair material directly or indirectly. The skin and soft tissue of the penis have their natural advantages, and they are the best choices for hypospadias repair. After drawing on the experience of the application of skin soft tissue expansion in plastic surgery, cosmetic operation and other fields, we postulate that soft tissue expansion can be used for hypospadias repair. In the early period of hypospadias repair, we could utilize the soft tissue expander to expand the skin and soft tissue of the penis according to the type of hypospadias and repair material shortage extent. Theoretically, the method could ameliorate the appearance of the operated penis and diminish complications as well as provide sufficient repair material for hypospadias repair. The hypothesis would provide a new strategy for hypospadias repair. Animal and clinical trials will be carried out in the near future to confirm the effectiveness and safety of this method.