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1.
Aesthetic Plast Surg ; 42(1): 188-196, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29026957

RESUMO

BACKGROUND: The inverted peno-scrotal flap method is considered the standard method of vaginoplasty in male-to-female genital reassignment surgery. Though with numerous advantages, the method has its limitations regarding skin texture, lack of inherent lubrication, and that the tissues for creating the labia depend on the amount of tissues remaining after vaginoplasty. Our purpose was to describe the procedure and outcome of vaginoplasty applying a new technique: autologous buccal micro-mucosa free graft combined with posterior scrotal flap transfer, which could solve some of the problems the previous methods had. METHODS: Nine male-to-female transsexual patients received our new method of vaginoplasty from July 2010-October 2015. We described the details of the surgical procedure and evaluated the long-term anatomical and functional outcomes. RESULTS: In a mean clinical follow-up period of 25.3 months and phone interview follow-up of 50.3 months, we observed that the neovaginas in the nine cases were all of sufficient volume, lined with mucosa, with natural mucosal discharge. The oral donor sites resulted in no visible scars or malfunction. Eight patients experienced uneventful postoperative periods, while one patient suffered from scrotal flap prolapse. All the patients were sexually active and reported sexual satisfaction, with no need of lubrication. CONCLUSION: The reported technique achieves the outcomes of creating a neovagina of sufficient volume, without serious stenosis in long-term follow-up. The neovagina is lined with mucosa and has appropriate lubrication as well as good sexual sensation. The reported method is easy and economical to perform and retains enough tissues for vulvoplasty to achieve a superior cosmetic appearance, with rare risk of complications and donor area malfunction. Additionally, this technique is feasible and advantageous to the patients who have insufficient peno-scrotal skin for neovaginal lining as well as those with unfavorable previous vaginoplasty. All of these indicate that this technique is a promising option for vaginoplasty in male-to-female transsexual surgery. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Retalhos de Tecido Biológico/transplante , Mucosa Bucal/transplante , Escroto/cirurgia , Cirurgia de Readequação Sexual/métodos , Transexualidade/cirurgia , Vagina/cirurgia , Adulto , Autoenxertos , Terapia Combinada , Feminino , Sobrevivência de Enxerto , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Projetos Piloto , Prognóstico , Qualidade de Vida , Medição de Risco , Escroto/transplante , Resultado do Tratamento , Adulto Jovem
2.
Int J Gynaecol Obstet ; 130(1): 14-8, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25754141

RESUMO

OBJECTIVE: To review data from patients who have undergone hymenoplasty with a novel surgical technique, termed the STSI (suture three stratums around the introitus) method. METHODS: In a retrospective study, data were reviewed from patients who underwent hymenoplasty by STSI at a center in Beijing, China, between January 2010 and January 2014. Patients were scheduled to attend a follow-up appointment 1 month after surgery. Long-term follow-up was conducted by telephone. Follow-up data and preoperative and postoperative photos were assessed. RESULTS: Overall, 125 patients had undergone hymenoplasty using the STSI method. Only 1 (0.8%) patient had an early postoperative complication (uncontrolled bleeding). Among the 99 patients who returned for follow-up at 1 month, healing was recorded for 91 (91.9%). Long-term follow-up suggested that no patient had persistent dyspareunia, menstruation changes, or other health problems after the surgery. Among 51 patients who reported sexual intercourse since the surgery, 47 (92.2%) were satisfied with the outcome and 28 (54.9%) reported blood loss during the first intercourse. CONCLUSION: The STSI method seems to be an effective, enduring, and safe technique of hymenoplasty.


Assuntos
Hímen/cirurgia , Complicações Pós-Operatórias , Adulto , Pequim , Coito , Dispareunia , Feminino , Hemorragia , Humanos , Estudos Retrospectivos , Inquéritos e Questionários , Adulto Jovem
3.
Obstet Gynecol ; 123(5): 951-956, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24785845

RESUMO

OBJECTIVE: To evaluate the technical feasibility and anatomical and functional outcomes of one-stage vaginoplasty with autologous buccal micromucosa. METHODS: We retrospectively reviewed our experiences with 38 patients with vaginal agenesis treated with primary surgery from June 2006 to April 2012. All patients underwent transvestibular vaginoplasty with autologous buccal micromucosa. We describe the details of this technique and evaluate the long-term anatomical, functional, and sexual outcomes. RESULTS: A total of 38 patients (33 with Mayer-Rokitansky-Kuster-Hauser syndrome and five with complete androgen insensitivity syndrome) were included in the present study. The mean operative time was 86.4 minutes (range 75-120 minutes). The mean blood loss was 68.5 mL (range 40-80 mL). At a mean follow-up of 33.5 months (range 15-76 months), the mean depth of the neovagina was 8.5±0.66 cm (range 7-10 cm), the mean circumference was 12.3±1.24 cm (range 10-15 cm), and the mean volume was 100±8 mL (range 85-120 mL). By histologic examination, we found the neovaginal mucosa was stratified nonkeratinized squamous mucosa and had secretory function. The mean female sexual function index score of the 32 sexually active patients was 28.8±2.1. No spouse reported discomfort during intercourse. The mean postoperative dependence on the vaginal stent was 15±2.1 months (range 9-20 months). CONCLUSION: Transvestibular vaginoplasty with autologous buccal micromucosa is an effective and feasible approach for patients with Mayer-Rokitansky-Kuster-Hauser syndrome and complete androgen insensitivity syndrome. The procedure has satisfactory long-term anatomical and functional results. LEVEL OF EVIDENCE: III.


Assuntos
Procedimentos Cirúrgicos em Ginecologia/métodos , Mucosa Bucal/transplante , Vagina/anormalidades , Vagina/cirurgia , Transtornos 46, XX do Desenvolvimento Sexual/cirurgia , Adolescente , Adulto , Síndrome de Resistência a Andrógenos/cirurgia , Perda Sanguínea Cirúrgica , Coito , Anormalidades Congênitas/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Ductos Paramesonéfricos/anormalidades , Ductos Paramesonéfricos/cirurgia , Duração da Cirurgia , Estudos Retrospectivos , Sexualidade , Stents , Adulto Jovem
4.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 29(2): 87-90, 2013 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-23772482

RESUMO

OBJECTIVE: To assess the functional result of a "Two in One" urethroplasty which combined oral mucosa graft and local flap. METHODS: 17 patients with hypospadias underwent a "Two in One" urethroplasty, which combined buccal mucosa and local flap for urethral reconstruction. Uroflowmetry was performed 1 day before and 1 year after operation. The urine flow rate, voided volume and urine flow curves were detected using a rotating sensor. The results of maximum urine flow rate (Qmax) were expressed as percentiles and compared to the Toguri value from normal children. RESULTS: Before corrective operation, 12 of 17 patients (70.6%) produced a plateau urine flow curve. 5 patients (29.4%) produced a very low flow curve. The average maximum flow rate was (7.89 +/- 2.29) ml/s per second compared to Toguri values, 12 of 17 patients (70.6%) had a Qmax below the normal 5th percentile. After a "Two in One" urethroplasty, a hell-shaped curve was obtained in 10 patients (58.8%). The maximum flow rate was (11.30 +/- 3.01) mL/s per second. 7 of 17 patients (41.2%) had a Qmax above the normal 25th percentile, 8 patients (47.1%) had a Qmax between the normal 25th percentile and 5th percentile, only 2 patients (11.8%) had a Qmax below the 5th percentile. CONCLUSIONS: The functional result of the "Two in One" urethroplasty is ideal. The maximum urine flow rate of the patients increases after the operation.


Assuntos
Hipospadia/fisiopatologia , Hipospadia/cirurgia , Uretra/fisiopatologia , Uretra/cirurgia , Pré-Escolar , Humanos , Masculino , Resultado do Tratamento
5.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 27(1): 31-5, 2011 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-21548385

RESUMO

OBJECTIVE: To investigate the histologic effect of botulinum toxin type A (Botox A) injection on myocutaneous flap expansion in minipigs model. METHODS: Seven minipigs were included in this study. Two symmetric tattoo area, 10 cm x 6 cm in size, were selected on the bilateral flank of the pigs. The Botox A was injected into one tattoo area randomly, 4 U every point, 2 cm apart, with a total dose of 96 U. The same dose of sterile normal saline (0.9%) was injected in the same fashion on the opposite side as control. 3 days after injection , two 200 ml expanders were inserted beneath the cutaneous muscle at the tattoo area. After complete expansion of 200 ml, the specimens were drawn from both groups symmetrically and were stained by means of HE and Masson. The histologic changes of myocutaneous flap were compared. Thickness of each layer in myocutaneous flap was measured in histological section. RESULTS: The thickness of cutaneous muscle, capsule, dermis were (275.74 +/- 28.93) microm, (468.03 +/- 34.28) microm, (1990.79 +/- 102.10) microm in Botox group, and (409.13 +/- 44.63) microm, (626.55 +/- 44.05) microm, (2508.44 +/- 70.71) microm in saline group, respectively, show a significant difference between the two groups (P < 0.01). The Masson stained slice showed that collagen average gray of capsule in Botox group was 185.38 +/- 9.56, which was significantly higher than that in the saline group (120.77 +/- 10.31, P < 0.01). Light microscope (HE stained sections ) showed that muscle in Botox group was significantly atrophy and cross-section of muscle fiber decreased. The muscle fiber in saline group was generally normal. It was observed through transmission electron microscope that the light and dark band of muscle cell became fuzzy and the Z line bending in Botox group. The light and dark band in saline group arranged neatly, the Z line was clear. CONCLUSIONS: Application of Botox A in myocutaneous flap expansion can make the muscle atrophy and reduce the content of collagen in capsule layer, making the myocutaneous flap thinner which is suitable for reconstruction in face and neck.


Assuntos
Toxinas Botulínicas Tipo A/farmacologia , Retalhos Cirúrgicos , Expansão de Tecido , Animais , Feminino , Masculino , Suínos , Porco Miniatura
6.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 27(1): 4-7, 2011 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-21548378

RESUMO

OBJECTIVE: To discuss the treatment of congenital hypospadias in infancy. METHODS: After correction of chordee, the tubed oral mucosa was used to prefabricate urethra in penis as free graft. The urethral anastomosis was performed at the second stage. The scrotum fascia flap, pedicled with scrotal artery, was transferred to cover the penile defect. RESULTS: From Jan. 2007 to May 2010, 42 cases were treated. The tubed oral mucosa was 3.0-4.0 cm in length, and 0.6-0.8 cm in diameter. The maximum size of scrotum flap was 1.5 cm x 3.0 cm. Urethral fistula happened in two cases due to necrosis at the distal end of scrotal flap, which was healed spontaneously after dressing for 1-2 weeks. Primary healing was achieved in all the other cases. After operation, the 26 cases have been visited for 6 months to 3 years, no urethra fistula , narrow and the penis curved. There is an universal urinate for oneself and a good form. CONCLUSIONS: The tubed oral mucosa can be used to prefabricate urethra, which is anastomosed at the second stage. The tubed oral mucosa combined with scrotal fascial flap which has a reliable blood supply, is very suitable for hypospadias in infancy.


Assuntos
Hipospadia/cirurgia , Mucosa Bucal/transplante , Retalhos Cirúrgicos , Anastomose Cirúrgica , Pré-Escolar , Fasciotomia , Humanos , Lactente , Masculino , Escroto/cirurgia
7.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 27(1): 1-3, 2011 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-21548377

RESUMO

OBJECTIVE: To discussed a new technique for multi-fistulas after urethroplasty in hypospadias. METHODS: 8 cases with postoperative multi-fistulas, which were not successfully repaired by previous treatment, were reoperated with tunica vaginalis flap combined with urethral stent and elastic dressing. The multi-fistulas were located between glan and scrotum. The number of fistulas was 3-7 (median, 5). RESULTS: Primary healing was achieved in all the 8 cases. The micturition and esthetic result were satisfied. 5 cases were followed up for 8-10 months with no recurrence of fistula. There was also no dysuria and penile curvature. CONCLUSIONS: Tunica vaginalis flap combined with urethral stent and elastic dressing is an effective technique for multi-fistulas after urethroplasty. It is easily performed with reliable result.


Assuntos
Complicações Pós-Operatórias , Retalhos Cirúrgicos , Fístula Urinária/cirurgia , Adolescente , Criança , Pré-Escolar , Humanos , Hipospadia/cirurgia , Masculino , Pênis/cirurgia , Complicações Pós-Operatórias/cirurgia , Stents , Testículo/cirurgia , Resultado do Tratamento , Fístula Urinária/etiologia
8.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 25(2): 96-100, 2009 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-19558160

RESUMO

OBJECTIVE: To study the application of tissue granule of oral mucous in plastic surgery. METHODS: Tissue granule of oral mucous was placed on glutin sponge and they were used for urethral (12 cases) and vaginal (14 cases) reconstruction in 26 cases. RESULTS: Satisfactory results were achieved in 24 cases. One case of urethral fistula and one case of urethral meatus stricture were happened. The two cases underwent secondary operation. CONCLUSIONS: Tissue granule of oral mucous membrane is good supply for repairing mucous defect. It has the advantages of high growth and survival rate, and less shrinkage. It is useful for urethral or vaginal reconstruction which are covered with mucous membrane.


Assuntos
Mucosa Bucal/transplante , Procedimentos de Cirurgia Plástica/métodos , Uretra/cirurgia , Vagina/cirurgia , Pré-Escolar , Feminino , Humanos , Hipospadia/cirurgia , Masculino , Uretra/anormalidades , Vagina/anormalidades , Adulto Jovem
9.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 25(2): 101-3, 2009 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-19558161

RESUMO

OBJECTIVE: To report the treatment of serious hypospadias in adults with free graft of tubed mouth mucosa and scrotal fascia flaps. METHODS: The tubed mouth mucosa was free grafted to fabricate the distal segment of urethra. It was anastomosed to the urethra at the second stage. The scrotal fascia flap was used to cover the penile wound. The biggest flap was 3 cm in width and 6.5 cm in length. RESULTS: From Jan. 2002 to Dec. 2007, 76 adults with severe hypospadias were treated. Infection happened in 4 cases. 2 cases had urethral fistula due to the partial flap necrosis which was healed automatically within 2-4 weeks. All the other patients healed primarily. CONCLUSIONS: It is a good method for the treatment of serious hypospadias in adults with scrotal fascia flaps and free graft of tubed mouth mucosa which is anastomosed to the urethra at the second stage.


Assuntos
Hipospadia/cirurgia , Mucosa Bucal/transplante , Procedimentos de Cirurgia Plástica/métodos , Escroto/transplante , Adolescente , Adulto , Anastomose Cirúrgica , Humanos , Masculino , Pessoa de Meia-Idade , Transplante de Pele , Retalhos Cirúrgicos , Adulto Jovem
11.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 24(6): 452-4, 2008 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-19241708

RESUMO

OBJECTIVE: To explore a technique for the treatment of severe hypospadias. METHODS: At the first stage, the proximal end of the urethra plate was divided and the chordee was corrected, followed by skin graft at the ventral surface of penis. The urethroplasty was performed at the second stage half a year later. RESULTS: From Feb. 2004 to Mar. 2005, 17 cases were treated successfully without any complication. After one year of following up, the appearance of glan and the urethral meatus was good and the chordee was corrected completely. The appearance of penis and scrotum was also satisfactory. CONCLUSIONS: The technique is easily performed and very suitable for penile and penoscrotal junction hypospadias with severe chordee.


Assuntos
Hipospadia/cirurgia , Transplante de Pele/métodos , Uretra/cirurgia , Adolescente , Adulto , Criança , Pré-Escolar , Humanos , Lactente , Masculino , Pênis/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Adulto Jovem
12.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 24(1): 36-8, 2008 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-18437982

RESUMO

OBJECTIVE: To observe the long-term apparent and structural change of the neo-urethra inner wall reconstructed with different kinds of tissue. To compare the difference between normal and reconstructed urethra for urethra reconstruction with more appropriate materials. METHODS: The neo-urethra inner wall was observed during operation, through urography and urethroscope. The tissue section of neo-urethra inner wall was observed through light microscope and electron microscope. RESULTS: With unchanged structure, the appearance of neo-urethra reconstructed with skin or mucosa could be close to normal urethra after a long time. Neo-urethra made of buccal mucosa possesses some of the most important basic structures for normal urethral microenvironment to form. The structure of neo-urethra made of bladder could be close to normal urethra after a long time. CONCLUSIONS: Buccal and bladder mucosa may be a better material than skin for urethra reconstruction.


Assuntos
Hipospadia/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Uretra/cirurgia , Adolescente , Adulto , Materiais Biocompatíveis , Criança , Feminino , Sobrevivência de Enxerto , Humanos , Masculino , Mucosa Bucal/transplante , Retalhos Cirúrgicos , Técnicas de Cultura de Tecidos , Engenharia Tecidual , Transplante de Tecidos/métodos , Adulto Jovem
13.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 24(3): 189-91, 2008 May.
Artigo em Chinês | MEDLINE | ID: mdl-18717352

RESUMO

OBJECTIVE: To explore a surgical treatment for obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS: 12 cases were treated during the period from Jan 1998 to Aug 2006. Partial soft palate was resected in rhombus shape from the middle to shorten the soft palate and enlarge the pharyngeal cavity. The uvula was reserved. RESULTS: The patients were followed up for six months to five years. There was no complication. Good results were achieved in 9 patients. 2 cases got some kind of improvement. No improvement happened in one case who received a partial tongue resection later. CONCLUSIONS: A rhombus shape excision of the soft palate from the middle is effective for the treatment of OSAHS with few complication.


Assuntos
Palato Mole/cirurgia , Apneia Obstrutiva do Sono/cirurgia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Faringe/cirurgia , Polissonografia , Apneia Obstrutiva do Sono/fisiopatologia , Língua/cirurgia , Úvula/cirurgia
14.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 23(4): 290-2, 2007 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-17926847

RESUMO

OBJECTIVE: To explore a method to repair larger cleft palate and lengthen soft palate without oral palate raw surface and scar formation, reduce the effect on maxilla and dental arch development. METHODS: A modified double opposing Z-plasty was used to lengthen soft palate and the nasal palate was closed by using large turn-over mucoperiosteal flaps on the oral surface of the junction of the hard palate and soft palate, oral raw surface on the palate was closed by a buccal myomucosal island flap. RESULTS: Thirty-six palates have been repaired by this procedure, all of which had satisfactory results without flap necrosis, infection, difficulties in opening mouth and facial nerve injury except two post-operative fistulas. Eight patients were followed up and all display complete velopharyngeal closure. CONCLUSIONS: Using unilateral buccinator myomucosal island flap with double opposing Z-plasty to repair wider palatal cleft can get a satisfactory soft palate lengthening. At the same time it can avoid bone surface exposing and scar formation; it is a safe and reliable procedure.


Assuntos
Fissura Palatina/cirurgia , Mucosa Bucal/transplante , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Adolescente , Bochecha/cirurgia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Adulto Jovem
15.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 23(6): 493-5, 2007 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-18269024

RESUMO

OBJECTIVE: To investigate the reconstruction of wide vermilion and orbicularis oris muscle defect with satisfactory outcome of aesthetics, sensation, and function. METHODS: The buccal musculomucosal flap based on the anterior buccal branches of the facial artery was used to reconstruct wide defect of vermilion and orbicularis oris muscle on upper or lower lip. RESULTS: 7 patients were treated. 5 cases had no postoperative complication. Partial mucosal necrosis on the tip of the flaps happened in 2 cases, but the underlying muscle survived and was re-mucosalized spontaneously. No other complication was observed. The sensation of cold, heat and touch could be detected on the first postoperative day. Electromyographic and electron microscopic studies confirmed innervation of the muscle in the flap. CONCLUSIONS: The buccal musculomucosal flap is a reliable reconstruction option for wide defect of vermilion and orbicularis oris muscle which can' t be reconstructed with conventional method. Satisfactory aesthetic and functional results can be achieved with the buccal musculomucosal flap.


Assuntos
Mucosa Bucal/transplante , Neoplasias Bucais/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Adolescente , Adulto , Bochecha , Músculos Faciais/patologia , Músculos Faciais/transplante , Feminino , Seguimentos , Humanos , Lábio/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Estadiamento de Neoplasias , Adulto Jovem
16.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 23(4): 297-300, 2007 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-17926850

RESUMO

OBJECTIVE: To sum up the methods repairing the congenital bladder exstrophy, and to evaluate the value of the abdominal fascial flap and the lower abdominal skin flap, the tensor fascia lata musculocutaneous flap treating the bladder exstrophy. METHODS: The abdominal rectus sheath and the fascia flap of obliquus externus abdominal and the lower abdominal skin flap, or the tensor fascia lata musculocutaneous flap were used to repair the abdominal wall defection, meanwhile repair the epispadias. The maximum field of the musculocutaneous flaps was 8 cm x 10 cm. RESULTS: 12 cases were cured. The bladder exstrophy and the abdominal wall defection were repaired very well. The musculus sphincter bladder neck was reconstructed. After the second operation, the cases could urinate under self-control. 2 skin flaps of 8 musculocutaneous flaps were necrosis and cured by skin grafting. CONCLUSIONS: Using the abdominal fascial flap and the lower abdominal skin flap, or the tensor fascia lata musculocutaneous flap, is feasible for repairing the bladder exstrophy and the lower abdominal wall defection. The continuous of the musculus sphincter bladder were renewed, and then the patients could urinate under self-control. When the ischemia of the musculocutaneous flaps had occurred, the tensor fascial was survived well.


Assuntos
Procedimentos de Cirurgia Plástica/métodos , Reto do Abdome/transplante , Bexiga Urinária/anormalidades , Músculos Abdominais , Adolescente , Adulto , Criança , Pré-Escolar , Fáscia/transplante , Feminino , Humanos , Masculino , Retalhos Cirúrgicos , Adulto Jovem
17.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 23(4): 340-3, 2007 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-17926863

RESUMO

OBJECTIVE: To establish an easily reproducible animal model of hypospadias and to test whether Atrazine can induce hypospadias in animal experiment. METHODS: From the 11th to 16th day after conception, 120 conceived SD rats were divided randomly into 6 groups: one coin oil group (1 ml/kg/d), two finasteride groups (10 mg/kg/d, 20 mg/kg/d), three Atrazine groups (25 mg/kg/d, 100 mg/kg/d, 200 mg/kg/d). When all pregnant rats had delivered, the new born rats were counted and the penis appearance, urethral orifice position and micturition were observed with magnifying lens and anatomy microscope. RESULTS: Hypospadias were found in new born male rats treated prenatally with Finasteride (10 mg/kg/d, 20 mg/kg/d) and 200 mg/kg/d Atrazine groups. The incidence was 28.30%, 67.03%, 10.23% respectively. Embryotoxic effects were observed at 25 mg/kg/d Atrazine group in 2 rats and associated with no severe maternal toxicity. CONCLUSIONS: (1) A hypospadias SD rats model can be established by Finasteride and it is easily reproducible. (2) The Atrazine was teratogenic to the SD rats, embryotoxic effects were observed at the low dose level and associated with no severe maternal toxicity.


Assuntos
Atrazina/efeitos adversos , Hipospadia/induzido quimicamente , Teratogênicos , Animais , Modelos Animais de Doenças , Feminino , Finasterida/efeitos adversos , Masculino , Gravidez , Ratos , Ratos Sprague-Dawley
18.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 23(6): 473-6, 2007 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-18269018

RESUMO

OBJECTIVE: To explore a more effective operative method for later facial nerve palsy. METHODS: A synthetically operative method of combining free graft of short extensor of toe with the technique of undermined inducted suture was used in 432 cases of later facial nerve palsy. RESULTS: 82% of 432 cases acquired satisfactory effect that consisted of static symmetry and dynamic rough symmetry in facial expression. 12% cases only acquired static symmetry in facial expression but the dynamic symmetry were insufficient. Unsatisfactory results were occurred in 6% cases as both the static and dynamic symmetry of their facial expression were insufficient, which acquired preferable results 2 another suspending operation 8 to 12 months later. 4 cases got post operation infection; through cases happel in foot and 2 in face. All of them were cured by the treatment of drain and antibiotic in 3 weeks. 46% cases were followed up by further consultation or telephone. The longest followed up was period 12 years, while the shortest was 1 year, and the average was 28 months. 93% patients were satisfactory with the results, and 7% patients thought that their facial expression symmetry were insufficient though their facial abnormality were improved obviously. CONCLUSIONS: The synthetically operative method of combining free graft of short extensor of toe with the technique of undermined inducted suture was an effective method for later facial nerve palsy, and most of the patients could acquired satisfactory results. This operative method is good for popularize because of its simple operation, slight tissue injury and fews complication post-operation.


Assuntos
Paralisia Facial/cirurgia , Músculo Esquelético/transplante , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/inervação , Técnicas de Sutura , Adulto Jovem
19.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 23(2): 118-20, 2007 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-17554874

RESUMO

OBJECTIVE: Attended to apply the acellular urinary bladder submucosa in the operation of the urethral duct reconstruction of penile hypospadias. METHODS: In 2 cases, the urethral ducts were reconstructed by using the acellular urinary bladder submucosa as dorsal half of the urethra, while the preputial island flap as ventral side. In the other patient, the urethral plate was incised, similar to Snodgrass operation, the matrix was fixed to the corpora cavernosa beneath. RESULTS: Uroflowmetry and the urethroscopy were been performed in the one year follow up. A bell-shaped flow curve was obtained in the patient after urethroplasty using matrix graft combined with a local flap, and no fistula, stricture was found after a year or half a year follow-up. CONCLUSIONS: The freeze-dried acellular urinary bladder submucosa had three-dimensional network structure, and the acellular urinary bladder submucosa graft combined with preputial flap for hypospadias repair provided satisfactory functional results.


Assuntos
Hipospadia/cirurgia , Mucosa/transplante , Bexiga Urinária/transplante , Pré-Escolar , Liofilização , Humanos , Masculino , Transplante Homólogo
20.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 22(2): 139-41, 2006 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-16736621

RESUMO

OBJECTIVE: To explore possible molecular mechanism of hypospadias and relationship of the mutation of SRD5A2 gene to hypospadias. METHODS: 96 blood samples from the patients with hypospadias were obtained and DNA was extracted from blood leukocytes. Polymerase chain reaction and direct sequencing were performed to analyze the coding regions of SRD5A2 gene. RESULTS: 8 mutations were detected from 14 cases, including 5 missense mutations, 1 synonymous mutation, 1 nonsense mutation and 1 frameshift mutation. The mutations are in 1st, 4th and 5th exon. Gln6stop, His232His, Phe234Leu and frameshift mutations are novel. CONCLUSIONS: Exon 4 is a hot spot region of mutation within SRD5A2 gene, and about 10 percent of hypospadiac patients complicated with SRD5A2 dysfunction or deficiency.


Assuntos
3-Oxo-5-alfa-Esteroide 4-Desidrogenase/genética , Hipospadia/genética , Mutação , Adolescente , Adulto , Doadores de Sangue , Estudos de Casos e Controles , Criança , Pré-Escolar , Análise Mutacional de DNA , Feminino , Humanos , Lactente , Masculino , Adulto Jovem
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