CAJ | 학술논문

目的探讨巨尿道口伴完整包皮型尿道下裂的认识和处理.方法回顾性分析2004年7月至2010年2月同一治疗组收治的巨尿道口伴完整包皮型尿道下裂病例.本组13例,年龄4岁5个月至12岁1个月,平均8岁1个月.就诊原因包括尿道口位置异常2例、阴茎外观短小1例、包茎10例.尿道开口于冠状沟3例,开口于阴茎远段10例.10例行尿道板纵切卷管尿道成形术(TIP)尿道成形,3例行Duplay尿道成形.术后随访3～45个月,平均9个月.结果 9例患儿成形尿道0.5～1.3 cm,平均0.9cm.术后尿瘘1例,再次手术矫治满意.其余病例外观满意,呈包皮环切术后外观,尿流尿线正常.结论 MIP型尿道下裂常因包茎手术时发现,阴茎弯曲多不明显,矫治时可保留尿道板,Duplay或TIP手术矫治效果满意.
목적 탐토거뇨도구반완정포피형뇨도하렬적인식화처리.방법 회고성분석2004년7월지2010년2월동일치료조수치적거뇨도구반완정포피형뇨도하렬병례.본조13례,년령4세5개월지12세1개월,평균8세1개월.취진원인포괄뇨도구위치이상2례、음경외관단소1례、포경10례.뇨도개구우관상구3례,개구우음경원단10례.10례행뇨도판종절권관뇨도성형술(TIP)뇨도성형,3례행Duplay뇨도성형.술후수방3～45개월,평균9개월.결과 9례환인성형뇨도0.5～1.3 cm,평균0.9cm.술후뇨루1례,재차수술교치만의.기여병예외관만의,정포피배절술후외관,뇨류뇨선정상.결론 MIP형뇨도하렬상인포경수술시발현,음경만곡다불명현,교치시가보류뇨도판,Duplay혹TIP수술교치효과만의.
Objective To discuss the recognition and management of megameatus with intact prepuce (MIP) variant of hypospadias.Methods From July 2004 to Febrary 2010,patients diagnosed with MIP were treated by a single pediatric urology team.The clinical data were analysed retrospectively.Thirteen patients were included with a mean age of 8 years and 1 month (range from 4 years and 5 months to 12 years and 1 month).Results The referral reasons included obvious penile deformity in 2 cases,inconspicuous penis in 1,and penile deformity recognized at attempted circumcision in 10.The meatus was positioned at sulcus coronarius in 3 cases,and distal shaft in 10.Snodgrass procedure was applied in 10 cases and Duplay in 3 for surgical correction.The mean follow-up period was 9 months (range 3 to 45 months).The mean length of urethral replacement was 0.9cm (range 0.5 cm to 1.3 cm).All patients attained satisfactory cosmetic and functional results.One patient had a fistula but eventually had a satisfactory outcome with redo surgery.Conclusions MIP is usually noted when circumcision was attempted.TIP and Duplay procedures should lead to satisfactory outcome.