男童尿道下裂的外科治疗

目的总结我院采用不同术式修复男童尿道下裂的经验。方法1996～2004年共收治男童尿道下裂患儿130例，年龄30个月～12岁，平均3．6岁，所有患者均行阴茎屈曲矫正和尿道成形术，其中膀胱黏膜代尿道术36例，阴囊中间皮肤岛状皮瓣法44例，带蒂岛状包皮、阴茎头隧道修复法（Dukett术）39例，带蒂岛状包皮、阴茎头隧道修复法加会阴皮管尿道成型术（Duckett—Duplay＇s）8例，尿道口基底血管瓣翻转法（Mathieu＇s）3例。结果130例患儿1次手术成功112倒，成功率86．1％。手术成功标准为：阴茎完全伸直，尿道开口龟头部位、阴茎外观尽量接近正常。结论尿道下裂的修复应根据患者的具体条件和手术者的操作技术而定，其中Duckett等术式外型美观，可作为首选。

Surgical Treatment of Boy Hypospadias with Different Procedures

Objective To investigate the treatment of hypospadias in boys with different procedures in our hospital.Methods 130 cases of hypospadias were treated from 1996~2004.All patients aged from 30 months to 12 years with a mean of 3.6years.130 boys with hypospadias were retrospectively analysed,bladder mucosa graft technique(36),scrotal island flap(44),Duckett procedure(39),Duckett plus Duplay techniques(8).Mathieu's(3).Results The success rate for bladder mucose graft technique was 83.7%(30/37),scrotal island flap 86.4%(38/44),Duckett procedure 87.2%(34/39).Duckett plus Duplay techniques 87.5%(7/8),mathieu's 100%(3/3),the mean of success rate was 86.1%(112/130).The successful operation is that the form of the penis is satisfactory with easy and smooth miction and a slit-like meatas after the repair.Conclusion The choice of surgical procedure for hypospadias repair should be individualized.Hypospadias with the external urethial orifice at the penis body could be treated first operatively by using Duckett.