Prefabricated skin tube of autologous tissue in the repair and reconstruction of urethra / 中国组织工程研究

ABSTRACT

OBJECTWE To explore the effect of prefabricated skin tube of autologous tissue on treating congential hypospadias, long-segment urethral stricture, and severe complications following hypospadias surgery. METHODS: Twenty-four male patients, who underwent treatment with prefabricated skin tube which was sutured from autologous scrotum, the penis foreskin, and testes sheath, and embedded in situ, for urethral stricture, hypospadias, severe complications following hypospadias, were selected and analyzed retrospectively. The age range was 5 to 56 years old, and the average was 14 years old. Of the 24 cases, 11 cases underwent urethroplasty for secondary hypospadias repair using skin tubes preset in the prepuce, nine cases of post-hypospadias complications were treated with prefabricated sheath canal, and four cases received prefabricated scrotal skin tube to treat long-segment stricture of the anterior urethral. The application of autologous tissue-prefabricated skin tube in the treatment of urethral stricture, hypospadias, and postoperative complications of hypospadias was observed.RESULTS: All the cases received a follow-up of 6 to 12 months. Of the 11 cases receiving urethroplasty for secondary hypospadias repair using skin tubes preset in the prepuce, one case was complicated with urethrostenosis, one was with anastomosis stricture and they were both cured following urethra dilatation. Of the nine cases of post-hypospadias complications treated with prefabricated sheath canal, there were 2 cases of bulky of penis. Of the four cases receiving prefabricated scrotal skin tube to treat long-segment stricture of the anterior urethral, one case was found complicated with anastomosis stricture. No other complications such as urethrocutaneous fistula and urethral diverticulum were found, and the flow rate was at or near the level of the peers.CONCLUSION: Leaming from the experience of plastic surgeries, skin tubes prefabricated with autologous tissues, such as penis foreskin, testis sheath, scrotal skin near the urethral, is beneficial to the recover of urethral function through urethroplasty for secondary hypospadias repair or repair of urethral defect. The incidence of urethrostenosis and anastomosis stricture is less by this way. It is a better surgical method to repair and reconstruct the urethra.