Denis Browne Urethroplasty

Denis Browne urethroplasty was proposed by Denis Browne (1953). A suitable strip is placed on the ventral side of the penis as the dorsal part of the new urethra. The epithelium spreads to form a tubular shape. The flap does not need to be sutured in a tubular shape during operation, thus saving the skin source and is suitable for various types of hypospadias. This procedure is usually performed 3 months after penile extension. The method introduced here is the improvement method of Wu Wenbin (1965). Treatment of diseases: hypospadias of children with hypospadias Indication Denis Browne urethroplasty is suitable for all types of hypospadias. Preoperative preparation 1. If the penis is too small, the male hormone therapy should be applied appropriately. After the penis is developed, the operation is performed again. 2. Prophylactic use of broad-spectrum antibiotics 1d before surgery and continued until wound healing. 3. Wash 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 1. Incision: The wire is threaded through the penis head for traction. The ventral side of the penis is symmetrically marked with gentian violet on both sides of the urethra. Two parallel lines represent the width of the buried strip. Children are 1 to 1.2 cm and adults are 1.5 cm. The two lines extend about 1 cm outward at the outer side of the coronary sulcus, and meet at the proximal end of the urethral opening. 2. Freely cut the skin of both penis: cut the skin and penis fascia along the marking line, and sneak the skin on both sides of the strip. Be sure to separate between the penis fascia and the penis white membrane, otherwise there will be more bleeding. If the anatomical level is unclear, a short longitudinal incision can be made on the dorsal side of the penis (this incision can also be used as a reduction incision) under the penis fascia, and then separated downwardly between the fascia and the tunica to the abdomen with a shank. The lateral incision is used to find the correct plane separating the ventral flap of the penis, and the skin on both sides is free to draw the suture to the center. 3. Embedding the strip: insert a porous silicone tube with a moderate diameter from the outer urethra, and suture the penis fascia with a 5-0 absorbable line continuously or horizontally to cover the catheter. If the penile fascia suture tension is large, in addition to continuing the penis skin on both sides of the free strip, it can also be used to reduce the longitudinal incision of the full-thickness of the penis. 4. Suture incision: After suturing the penis fascia, suture the subcutaneous layer and skin with 3-0 silk suture. Nylon mesh is properly pressure bandaged. 5. On the pubis on the bladder stoma.