Лечение проксимальных форм гипоспадии после повторных операций у детей

Abstract

The aim of the work was to study and analyse the methods of treatment of proximal hypospadias, including patients after repeated failed repairs. Surgical treatment of proximal hypospadias in children is especially challenging because of a great number of complications. The main kinds of complications are urethral defect (fistula), stenosis, urethral diverticulum, scarring, shortage of local plastic material. We analysed literature dealing with various methods of urethroplasty for treatment of children with proximal hypospadias after repeat operations. A promising direction in treatment of this cohort of patients is two-stage urethroplasty with the use of a buccal mucosa graft according to A.Bracka. The use of this method permits to create a urethra from buccal mucosa – the material that has a similar histological structure with the native urethra, and at the same time to solve the problem of tissue shortage. In the published results of treatment, one of the causes limiting the use of this technique is the presence of such a complication as hyperplasia or scarring degeneration of the mucosal graft after its transplantation. Publications dealing with the study of the histological structure of the transplanted buccal mucosa graft are reviewed. Key words: proximal hypospadias, urethroplasty, buccal mucosa graft, complications of hypospadias, urethral plate