彰化基督教醫院 外科部 泌尿科1中山學大學 醫學研究所2
The Reconstruction of Chordee -Sharing the experience of CCH in recent 30 Years
Jesun Lin 1,2,3, Herng-Jye Jiang 1, Jian Ting Chen 1, Bai-Fu Wang 1, and Ming-Chih Cho
1,Division of Urology, Department of Surgery, Children Hospital, Changhua Christian Hospital, Changhua
2, Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
3, Division of Pediatric Urology, Children Hospital, Changhua Christian Hospital
Purpose: It is the most troublesome event in the reconstruction of chordee including multiple attempts at redo hypospadias surgery. There are multiple factors which caused ventral curvature of the penis. We would review our 30 years experience in the management of chordee. The purpose of this article is presenting the problems in patients with recurrent events of chordee and the outcome of consequent surgery.
Materials and Methods: We reviewed the records of 88 chordee with or without hypospadias patients between January 1988 and December 2019. The presenting problems in chordee patients are various. We classify the main problems to be (1) distal (2) penile shaft (3) penoscrotal. The resolution methods are dorsal plication ,orthotomy and orthoplasty with dermal graft. We performed Mini-Vac vacuum drain in subcutaneous layer for prevention of hematoma and infection. We follow up the outcome of consequent surgery from 6months to more than ten years.
Results: The number of redo-operations for their presenting problems ranged from 1 to 3 attempts. The over all successful rate for distal type is about 90%, penile shaft type is 80% and the penoscrotal type is 60%. The successful surgery of the redo operation requires radical correction of all deformities.
Conclusions: We have to correct them in a single stage preferably. In redoing this reconstruction, we should be conversant with virtually all the existing methods of chordee reconstruction and be able to apply them appropriately. We follow up these patients to more than their adolescence.