METHOD FOR SURGICAL TREATMENT OF EXSTROPHY OF BLADDER WITH EPISPADIA FOLLOWED BY UROCLEPSIA AND DEFORMITY OF PENIS AT ADULT STAGE

摘要

FIELD: medicine.;SUBSTANCE: single-step full urogenital reconstruction is carried out. Extending urethroplasty is carried out by insular vascularised flap with the following tubularisation. Extending corporoplastic with using of autovenous flaps is carried out. Vascularised flap of rectus is formed. After rotation it's moved to the neck of the urinary bladder through the pubical area. The flap of rectus is fixed in the pubical area, meanwhile abdominal palstics is performed. And defect in the pubical area is eliminated and sutures of the neck of the urinary bladder are tightened. Arbitrary sphincter of the bladder is formed by splitting distal third part of the flap of rectus and wrapping around posterior urethra with formation of the sleeve. Devided carvenous body is rotated. Ventral transposition of neourethra with modeling of the spongious body through pedicle of island flap is carried out. Skin defect is covered by atopic skin flaps and penis is closed by local tissues and atopic scrota tissues.;EFFECT: method prevents from fibrous formation in operated area, ensures bladder continence and ability to independent urination, elongation of penis and elimination notal deformation of penis, getting of esthetic result with decrease of neourethra fistulas.;14 dwg, 1 ex