METHOD OF SURGICAL TREATMENT OF THE DEVELOPMENTAL DEFECT OF THE PENIS IN EPISPADIAS AND BLADDER EXSTROPHY IN BOYS Russian patent published in 2018 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, urology andrology of childhood and can be used to treat patients with coronary, stem, subtotal, total forms of epispadias, as well as all patients with bladder exstrophy. Surgery begins with a longitudinal incision along the midline in the anterior abdominal wall in the region of the bones, above the outer orifice of the urethra. After dissecting the skin, two incisions are performed on the bony bones and subperiosteal secrete the perineal muscles and the wall of the bladder, releasing the legs of the cavernous bodies from the lower branch of the pubic bone. Further, the skin of the penis is cut through the coronary groove, along its ventral and lateral surfaces. Then cut out two longitudinal sections of the mucosal flap in the area of the urethral area along the dorsal surface of the trunk of the penis, bordering the external aperture of the urethra. Next, a longitudinal dissection of the head tissue is performed at the apex, at the site where it is proposed to form the outer opening of the future urethra. Tissue of the head is tightened in the transverse direction by the inner screw-in seam. Isolate the flap of the urethral mucosa from cavernous bodies on the dorsal surface, the elements of the neurovascular bundle are identified, the cavernous bodies are released all the way from the base up to the apex. Dissect connective tissue scars on the dorsal surface of the penis. On the dorsal surface of both cavernous bodies of the penis in the upper and middle third, 10–15 surface transverse incisions of the gallbladder are performed successively on each cavernous body. Further, the flap of the mucosa of the mobilized urethral site along the dorsal surface of the penis is formed into the tube by a continuous seam PDS 6/0. Created neo -urethra (urethral tube) is lowered down between the divided cavernous bodies, which are then sewn together by nodal sutures. Stitch the edges of the dissected penis, the skin of the trunk of the penis and the foreskin is evenly distributed by screwing seams around the cavernous bodies, the wound on the trunk of the penis is layered in layers.

EFFECT: method ensures elimination of dorsal deformation of the penis, an increase in the length of its cavernous bodies, anatomically correct position of the penis and a vertically directed meatus (an external opening of the urethra), a uniform distribution of the foreskin along the coronoid groove.

1 cl, 6 dwg, 1 ex