FIELD: medicine.
SUBSTANCE: invention refers to medicine, namely to urology, and aims at surgical management of scrotal hypospadias. Method involves an enclosing incision around penis head 0.5 cm from the coronal sulcus with skin incision in proximal direction. Proximal urethra is mobilized from the cavernous bodies, the urethral stump is fixed more proximal to the cavernous bodies. White coat is dissected by transverse incisions along the ventral surface in amount of 3-4. Balanus is dissected along the middle line with mobilization of the head wings. Neo-urethra is formed by cutting a free graft in the form of a biconvex lens, which is laid from the meatus to the apex of the head and fixed to a gastric ulcer, and the flap is cut out on the feeding vessels from the outer leaf of the prepuce in the form of a biconcave lens. Passage is made in the flap base, through this passage the flap is transferred to the ventral surface and anastomosed with a hypospadic meatus and a fixed free graft to the apex of the head. Penis frenulum is modeled, for this purpose the flap portion is de-epidermised in the head portion and the head is sutured with U-sutures with the skin of the flap. If the amount of plastic material is sufficient, the free transplant is cut out of the internal leaf of the prepuce, if insufficient – from buccal mucosa.
EFFECT: method provides higher clinical effectiveness in hypospadias ensured by considerable reduction of cases of strictures and fistulas of the artifactual urethra, formation of a full voiding process and improved cosmetic result.
3 cl, 2 ex, 13 dwg
