Devine-Horton technique

Devine-Horton was first reported by Devine and Horton in 1961. Treatment of diseases: upper urethra Indication Devine-Horton is applied to the urethra opening in the middle of the penis with the penis lower, and the dorsal foreskin is abundant. 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. The 4th thread runs through the top of the penis head for traction. 2. Make a circular incision 0.5 cm below the coronary sulcus, make a longitudinal incision in the ventral side of the penis to reach the upper edge of the outer urethra, and make a circular incision around the outer urethra to reach the urethral sponge white membrane. The penile flap was placed close to the white membrane to the root of the penis, and the distal urethra was removed 0.8 cm and cut into a bevel to prepare for anastomosis with the new urethra. Cutting off the ventral fibrosis of the penis makes the penis lower curvature fully corrected, and cuts the fiber cord under the penis head to make the penis head straight. Make a "V" shaped incision in the ventral urethral plate of the penis head, and free the flank flaps on both sides to fully loosen it so as to wrap around the new urethra and the penis head. 3. Making a foreskin tube: According to the distance between the urethral opening and the tip of the penis, the width of the foreskin flap is 10% longer than the distance of the penis. The width is based on the stent drainage tube or the urethral circumference. The adipose tissue was cut off, and the degreased flap was wrapped around the inserted stent drainage tube, and the 5-0 absorbable wire was sutured into a skin tube for use. 4. Formation of urethra and penis head: cut both ends of the tube into a bevel, the edge of the suture is close to the ventral side of the penis, and the proximal end and the outer urethral slant are sutured with a 5-0 absorbable line, and the distal end and the urethral plate "V The skin flap is sutured into a new urethra. The flaps on both sides of the penis head were wrapped around the new urethra, and the distal end of the penis was sutured at the tip of the penis and the two wing flaps to form the outer urethra. 5. Repair the penis: trim the penile flap and wrap around the penis wound and the new urethra. 6. For the suprapubic bladder stoma or perineal urethra stoma.