الإحليل التحتاني بعد إصلاحات جراحية متعددة فاشلة: إدارة أنسجة القضيب المتندبة والإحليل غير الكافي

References

DOI: 10.4103/0970-1591.40621

• Those who underwent several previous failed surgical procedures (hypospadias cripple) which present with scarred tissues, inadequate urethra, abnormal meatus, fistula, and dehiscence of various severity.
• Multistage procedures find their best indications in multioperated hypospadias and, according to some, in proximal hypospadias when the urethral plate cannot be preserved.
• A rectangle of inner prepuce or buccal mucosa is grafted onto the ventral aspect of the penis with multiple fine stitches and subsequently immobilized with a "tie-over" pressure dressing.
• This reconstruction should allow the child to have micturitions standing up without pushing with a straight and wide stream and to access in adulthood to a satisfactory sexual life with straight erections.
• The three steps of this reconstruction are to straighten the penis by correcting the chordee, to refashion the missing urethra (urethroplasty) placing the urethral meatus at the tip of the glans and giving it a slit-shaped opening, and to rebuild the ventral aspect of the penis to get a normal looking penis with or without circumcision.