Urethroplasty

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. Indication Lower urethra. Contraindications Older, combined with severe heart, liver, kidney and other diseases and difficult to tolerate surgery. 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. Position: flat supine position, the legs can be slightly separated. 2. Incision: Two parallel incisions were made on both sides of the ventral midline of the penis, with a spacing of 1.5 to 2.0 cm, an upper end 0.5 cm from the coronary sulcus, and a lower end 0.5 cm below the urethral opening. The upper and lower ends of each incision are made into a transverse incision, and the two transverse incisions at the upper end are not connected, the spacing is above 0.5 cm, and the two transverse incisions at the lower end are connected around the lower part of the urethra to form a, b two flaps. 3. Formation of the urethra: first placed into the catheter through the urethral orifice to support, and then separate a flap under the fascia. After the b-valve is separated to 0.5-1.0 cm, the catheter is wrapped around the catheter to form a tubular shape with the wound facing outward. Be careful not to injure the subcutaneous vascular network, and the original urethral opening is included in the pipeline. Intermittent suture with 5-0 nylon thread or silk thread, the knot was hit on the inner surface of the tube to facilitate self-shedding after surgery. If necessary, add a needle to the subcutaneous part to reinforce. 4. Close the wound: Lift the a-valve to the opposite side to cover the formed urethra. Stitch with 5-0 nylon thread or silk thread on the contralateral skin. At the end of the operation, the catheter was removed and a rubber strip was placed in the newly formed urethral opening. complication Wound infection.