尿道下裂的术式选择-会阴型和阴茎阴囊型

Choice of surgical procedure for hypospadias perineal and penoscrotal forms

摘要:

目的 总结会阴型尿道下裂和阴茎包皮岛状皮瓣一期修复阴茎阴囊型尿道下裂的最佳术式.方法 将2000年1月至2015年1月本院收治的38例尿道下裂患儿,其中阴茎阴囊型25例、会阴型13例,按照尿道下裂的不同类型进行阴茎包皮岛状皮瓣设计、移位和尿道成形修复手术.阴茎包皮岛状最长7.5cm,宽1.5～1.8cm.结果 术后11例发生尿瘘,其中会阴型5例,阴茎阴囊型6例,经修补后痊愈.本组患者术后阴茎外形正常,无扭曲或臃肿、尿道开口达到正常解剖部位,均能正常排尿或有很大改善接近正常.结论 阴茎包皮岛状皮瓣一期修复阴茎阴囊型和会阴型尿道下裂是一种较为安全有效的手术方法.

Abstract:

Objectives To investigate the best surgical procedures for one-stage penile/preputial island cutaneous flap repair of perineal and penoscrotal hypospadias.Methods According to the different forms of hypospadias,perineal/preputial island cutaneous flap design,transposition and urethroplasty were performed in 38 children with hypospadias in our hospital from January 2000 to January 2015,including 25 cases of penoscrotal form and 13 cases of perineal form.The maximum length of perineal penile/preputial island was 7.5cm,with a width of 1.5 ～ 1.8cm.Results Among 11 postoperative urinary fistula,5 cases of perineal hypospadias and 6 cases of penoscrotal hypospadias were cured by repair.After surgical treatment,all patients in this group had a normal shape of penis,without curvature or tumefaction and with a normal anatomic position of the urethral meatus,and were able to urinate normally or improved greatly to near normal.Conclusions One-stage penile/preputial island cutaneous flap repair of penoscrotal and perineal hypospadias is a relatively safe and effective surgical method.