尿道下裂の治療経験 --主としてDenis-Browne-Crawford変法の成績と問題点--

Abstract

53例の尿道下裂の手術成績を報告した.Denis-Browne-Crawford変法による手術直後の成功率は48%にすぎず, 瘻孔, 狭窄による合併症が多かった.これらの合併症に対しては, 適切な処置により, 最終的に手術目的を達成したものは93%となった

Fifty-three hypospadias repair operations performed of our hospital since August 1973 were examined. The success rate for the modified Denis-Browne-Crawford urethroplasty was only 48%. Major complications were fistulas, meatal stenosis and urethral strictures. A final success rate of 93% was achieved after management of complications. The causes of complications were analysed to be 1) surgeon's lack of skill and experience due to our equal-opportunity policy in patient care, 2) ventral scar formation after the Byars' straightening operation, 3) technical difficulties in the modified Denis-Browne-Crawford urethroplasty, and 4) inadequate postoperative management. Challenge to the urethral meatal advancement and widening of the range of the indications for one-stage hyposapatias repair are emphasized.