ABSTRACT
Rapid allele-specific PCR primer was designed base on Cytb 155 A/T single nucleotide polymorphism, DNA was extracted by alkaline lysis and the PCR reaction systems including denatured and annealing temperature and cycle numbers were optimized. The results were performed to authenticate Ranae Oviductus and its 4 adulterants. When 100×SYBR Green I was added in the PCR product at 90 ℃ denatured 3 s, 62 ℃ annealing 20 s and 32 cycle. Ranae Oviductus visualized strong green fluorescence under 365 nm UV lamp whereas adulterants appeared negative. The whole process can be completed in 40 minutes．The established method provides the technical support for authentication of the Ranae Oviductus.
ABSTRACT
<p><b>OBJECTIVE</b>To review the indications, techniques and complications of reoperation for failed hypospadias repair using modified Mathieu urethroplasty.</p><p><b>METHODS</b>Using modified Mathieu urethroplasty, we treated 24 hypospadias patients aged 3-12 (mean 4.5) years for whom the first (n = 20) or the second hypospadias repair (n = 4) had failed, including 13 cases of large coronary sulcus urethrocutaneous fistula, 5 cases of urethral meatus retraction and 6 cases of anterior urethra dehiscence. The modified procedure involved median longitudinal incision of the urethral posterior wall, dorsal tunica albuginea plication under the vascular and nerve bundle, and double dartos flap protection of the neourethra.</p><p><b>RESULTS</b>Of the 24 patients, 19 (79.2%) were successfully treated by the first operation, which achieved desirable straightness, good cosmetic appearance and normal urethral meatus of the penis, without postoperative complications. Small urethrocutaneous fistula developed in 4 cases, of which 3 were cured by fistula repair and 1 self-healed. Urethral meatus stenosis occurred in 1 case, which was restored by meatal dilation. Urethrocele and urethrostenosis were not found in any of the cases. Two cases received urethroscopy postoperatively, which revealed no hypertrophic cicatrix at the site of median longitudinal incision in the urethral posterior wall.</p><p><b>CONCLUSION</b>Modified Mathieu urethroplasty can be applied to hypospadias reoperation, particularly in such cases as large coronary sulcus urethrocutaneous fistula, urethral meatus retraction and anterior urethra dehiscence. The modified procedure includes median longitudinal incision of the urethral posterior wall, dorsal tunica albuginea plication under the vascular and nerve bundle, and double dartos flap protection of the neourethra.</p>
Subject(s)
Child , Child, Preschool , Humans , Male , Hypospadias , General Surgery , Plastic Surgery Procedures , Methods , Reoperation , Treatment Outcome , Urethra , General Surgery , Urologic Surgical Procedures, Male , MethodsABSTRACT
Objective To investigate the value and strategy of staged repair in hypospadias surgery.Methods One hundred and sixty-three cases of severe proximal and complex hypospadias were retrospectively analyzed.According to the operation process,all the cases were divided into 2 groups.Staged repair group:there were 46 cases in all,included 31 cases of severe proximal hypospadias and 15 cases cases of complex hypospadias,the diorthosis for penis curvature and urethral reconstruction were completed by staged.One-stage repair group:there were 117 cases as control group,included 108 cases of severe proximal hypospadias and 9 cases of complex hypospadias,their diorthosis for penis curvature and urethral reconstruction were completed in single stage.Results The adverse factors such as a serious deformity in penis or limited local tissue were more common in staged repair group,and the conditions of repair were worse than one-stage repair group.In severe proximal hypospadias,the incidence of penis curvature in staged repair group was obvious lower than one-stage repair group (P ＜ 0.05),within the period of follow up,which only 1 case (3.2％) showed a slight penis curvature.However,there were 23 cases (21.3％) with penis curvature in one-stage repair group,in which 7 cases showed up penis torsion,20 cases with a bowstring shape of breviate urethra in penile ventral,and 19 cases(17.6％) needed reoperation.Compared of 2 groups,the incidences of urinary fistula,urethral stricture and urethral diverticulum showed no difference in statistics (all P ＞ 0.05).In complex hypospadias,the incidence of urinary fistula in staged repair group was significantly lower than one-stage repair group,and then the rate of urinary fistula was 20.0％ vs 66.7％ (P ＜ 0.05).The incidence of penis curvature,urethral stricture and urethral diverticulum showed no difference in statistics (all P ＞ 0.05).Conclusions Staged repair is relatively simple and effective,can be used in the treatment of severe proximal or complex hypospadias,especially in the cases with a worse condition.The mode of operation should be chosen not only according to the penial state and tissue conditions,but also combined with the technology and experience of the surgeon,and avoid the forced of one-staged repair for hypospadias.