V 7与睾丸鞘膜瓣修复Epispadias

                               
登录/注册后可看大图

Purpose Primary epispadias is a rare congenital malformation that afflicts about 1 in 80,000 children. The surgical repair originally described by Cantwell over 100 years ago is fundamentally sound and incorporates several important steps to achieve an optimal result. Materials and Methods A 9-month-old male with penopubic epispadias presents with voiding cystourethrogram that demonstrates a moderate-sized bladder, partially competent bladder neck and no reflux. Established surgical principles of identification of laterally displaced neurovascular bundles, preservation of the ventral mesentery to the urethral plate, mobilization of urethral plate off the corporal bodies with ventral relocation and dorsomedial rotation of the corporal bodies are demonstrated. A tunica vaginalis flap is harvested from the right testis and secured as a third layer over the urethral repair. Conclusions This video demonstrates a modified Cantwell-Ransley technique for epispadias repair which employs a tunica vaginalis flap to reinforce the urethra.