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Tunneled tubularized bladder mucosal graft for long urethral reconstruction:is it a reliable option in selected complex cases in children and adolescents?

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Plastic and Aesthetic Research 2022年第1期9卷 585-595页

作者： Alaa El-Ghoneimi Amane-Allah Lachkar Pauline Lopez Annabel Paye-Jaouen Matthieu Peycelon Department of Pediatric Surgery and Urology University Hospital Robert-DebréAPHPUniversitéParis CitéParis 75019France National Reference Center for Rare Urinary Tract Malformations(MARVU) Paris 75019France

Aim:We analyzed the use of tubularized tunneled bladder mucosa graft(TBMG)and its application as a salvage procedure or as primary surgery for long urethroplasty in children and *** attention was given to a new method to harvest a long bladder mucosa graft through a minimal ***:We analyzed the files of 10 patients who underwent TBMG urethroplasty at median age of 105 months(range 20-195 months).The indications were perineal hypospadias cripple in two,masculinizing genitoplasty for ovotesticular Ovotesticular Disorder of Sex Development(DSD)in two,perineal hypospadias in four,duplicated urethra in one,and complications of circumcision in *** reconstruction was performed in all *** first stage was removal of all fibrous tissues and efficient treatment of curvature and skin *** a minimal delay of one year,a free bladder mucosa graft was harvested through a minimal detrusotomy and *** of the graft was proceeded from the perineal urethrostomy to the ***:The graft was successfully harvested through the minimal detrusotomy approach for variable lengths of urethroplasty;the median length was 10.5 cm(range 8-16 cm).The median follow up was 61.7 months(range 18-160 months).TBMG was the last surgery with no redo in five cases(50%).Long stricture occurred in one case of primary perineal hypospadias and needed a redo staged *** patients performed self-dilatation for distal ***:The tunneled bladder mucosa tube graft technique represents a good alternative for a long urethroplasty in patients with a paucity of healthy *** minimal detrusotomy technique for graft retrieval may reduce graft harvesting morbidity.

关键词： Hypospadias bladder mucosa graft hypospadias cripples urethra reconstruction

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