FIELD: medicine.
SUBSTANCE: invention refers to medicine, namely to pediatric urology. The technical effect consists in thorough seal of the urethral tube by creating a two-row suture. The penis stem skin is mobilised to its base. The fibrous cord is excised. A rectangular flap equal in length of the urethra deficiency, and in width of a circumference of the created urethra is cut out on a dorsal surface of the mobilised skin. It is sutured by an uninterrupted reversing suture in a catheterised tube to form a non-urethra. On a ventral surface of the balanus to the right and to the left from the mid-line, there are two surfaces de-epidermised in the form of right-angled triangles with the vertexes turned to the balanus, and the sides turned to the mid-line. In a proximal portion of a skin wound, an opening is formed by pulling tissues apart, equal in diametre to the penis stem to be moved through said opening to the dorsal side. The proximal end of the artificial urethra is end-to-end sutured together with hypospadic meatus, while the distal end is anchored to the ventral surface of the balanus by interrupted sutures. The first suture is applied between the dorsal edge of the artificial meatus and the vertex of the de-epidermised triangular surface. Other two sutures are applied between the lateral edges of the artificial meatus and the lateral edges of the vertex. The excess skin edges of the preputial sac are anchored with interrupted sutures to the lateral edges of the triangular surface. A wound on the dorsal surface of the penis stem is closed with uninterrupted suture to the coronal sulcus. The wound edges of the balanus are sutured together with uninterrupted blanket suture with the wound edges of the dorsal surface. A skin defect on the ventral surface of the penis stem is closed longitudinally with uninterrupted blanket suture. When suturing the flap in the tube, a basic knot is made in a proximal angle of the wound with a stick in being at 1 mm from the basic knot and inclined 45°. An intracutaneous stitch is made without touching with a wound edge. A needle is stuck in the formed elevation of dermal tissue crosswise between a stick-in point and a stick-out point. A ligature is extended. Another stick in is at 1 mm from the basic knot and the wound edge at an angle 45° and further by the previously described technique.
EFFECT: method combines high cosmetic and good seal effect.
1 ex, 2 dwg
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Authors
Dates
2010-11-20—Published
2009-04-21—Filed