后型尿道下裂二期膀胱黏膜半管状重建尿道术的临床研究

目的探讨采用二期膀胱黏膜半管状重建尿道术治疗后型尿道下裂的临床研究。方法81例后型尿道下裂病例采用二期手术：一期手术将阴茎海绵体完全伸直，阴茎包皮内板和背侧皮肤预置于阴茎腹侧；二期手术采用半管状阴茎阴囊皮肤＋半管状膀胱黏膜成形尿道术。结果81例后型尿道下裂患者矫形后形态几乎接近正常。手术成功率为86．4％（70／81），尿瘘发生率为13．6％（11／81），8例（9．9％，8／81）发生尿道狭窄，经尿道扩张治疗后痊愈。结论二期膀胱黏膜半管状重建尿道术治疗后型尿道下裂的手术成功率较高，值得临床推荐。

Two-stage semi-tubular urinary bladder reconstruction surgery for the treatment of posterior hypospadias

Objective To investigate the clinical efficacy of urethra reconstruction with semi-tubular bladder mucous membrane to treat severe hypospadias through two-stage surgery. Methods 81 patients with severe hypospadias received twostage surgery. The first stage was to straighten the penis and pre-place the internal penis plate and penis dorsal skin to the ventral side. The second stage was to reconstruct the skin of penis, scrotum and urethra with semi-tubular bladder mucous membrane. Results After the surgery, the penis of all patients returned almost to normal in morphology, with a success rate of 86.4% （70/81）. Urinary fistula occurred in 11 cases （13.6 % ） and urethral stricture in 8 cases （9.9% ）, who recovered after urethral dilation. Conclusions The two-stage surgery to reconstruct urethra with semi-tubular bladder mucous membrane is effective to treat severe hypospadias.