dorsal penile urethroplasty (broadbent)

Hypospadias refers to the male urethral opening not at the forefront of the penis, but under the glans, the ventral side of the penis, the base of the penis or the perineum. Often accompanied by penile curvature and testicular insufficiency (cryptorchidism), some boys have to urinate in the squatting, and more difficult to distinguish between men and women, causing great suffering to the family. Hypospadias is not uncommon, with about one in every 300 boys. In addition to the opening of the glans, there is no need for surgical correction, and the rest, if not corrected, may affect penis development or cause infertility. Treatment of diseases: hypospadias of children with hypospadias Indication Have a hypospadias. Preoperative preparation First, we must identify the gender. Secondly, the perineum should be cleaned with 1:1000 Xinjieer liquid on the 3rd day before surgery, once every night for 10 minutes. The area was shaved 1 day before surgery. It is necessary to perform bladder fistula, so that the urine flow can be diverted to avoid wet dressing and infection. Surgical procedure 1. Incision position: The thick silk thread runs through the penis head as a traction, and a straight incision is made on both sides of the urethral groove, deep into the penis fascia, and the incision bypasses the outer urethra. The ventral side of the penis was 0.2 cm from the coronal sulcus as a transverse incision, and each side was cut 1 to 2 cm. 2. Incision: Two parallel oblique incisions are made around the urethral opening on the ventral side of the penis. The spacing is about 1/3 of the circumference of the penis. The two incisions are oblique to the dorsal side of the penis and directly reach the coronal groove, which may slightly exceed the dorsal midline. They are then joined together, which is the flap c that forms the sheath. 3. Penis straightening, urethroplasty: First make an additional incision along the coronary sulcus to make the flap a. The a-valve is picked up to reveal the fiber band in the center of the ventral side of the penis, which is completely removed and the penis is fully extended. Then, the catheter is placed into the catheter from the urethral opening, and the circumference of the c-valve is separated and wrapped around the catheter to form a tubular shape with the wound facing outward. The suture is interrupted with a 5-0 nylon thread or a thread, and the knot is hit inside the tube. Let it fall off after surgery. A tunnel is made in the head of the penis, and the distal end of the prepared pipe is buried in the tunnel, and the outer mouth of the pipe is sutured and fixed with the wound edge of the penis head. Although the urethra thus formed is slightly curved, it does not affect the smooth flow of urine. 4. Close the wound: separate the a and b lobes, and make an additional transverse incision in the coronal sulcus. Pull the flap to the ventral center and make two rows of sutures (the same pelvic urethroplasty). At the end of the operation, the catheter is pulled out, the rubber strip is placed in the newly formed urethral opening, and the penis is fixed on the abdominal wall with a traction wire or a thin wire.