一期的尿道形成術の経験 : Asopa法の変形について

抄録

A modified technique of Asopa's one stage urethroplasty was carried out in ten patients with hypospadias (1 distal penile, 5 proximal penile and 4 penoscrotal type). The modified technique is: 1) Hypospadia is repaired in one stage, providing a better result with reduced morbidity and hospitalization cost. 2) Both of a complete chordectomy used in many multiple stage techniques and a skinlysis recently proposed by Smith, Allen and King are accompolished in the same stage, making this technique applicable to the hypospadias from distal penile type to penoscrotal type. 3) A construction of neourethra using a vascularized flap of prepucial hairless skin provides the considerable advances as mentioned by Hodgson. 4) A completion of the urethra to the tip of glans accompanies the glans plasty, making a normal appearance of penis. 5) No urinary diversion is necessary. 6) A fistula can be formed at the junction of old and neourethra, but can be closed easily. (4 patients developed fistulas and surgical closure was done successfully). 7) Penile rotation could occur rarely but can be prevented by careful design to close skin.