保留尿道板一期尿道成形治疗尿道下裂

目的：探讨尿道板在尿道成形术中的应用价值。方法：对31例尿道下裂患儿施行保留尿道板一期尿道成形术。术式主要有Mathieu术(14例)、Onlay island flap术(7例)和Snodgrass术(10例)。31例均为阴茎体型尿道下裂。表现为阴茎轻度下弯，其中7例为第一次尿道成形术失败者。结果：总成功率为90．3％。术后2例出现尿漏，1例出现尿道狭窄。全部病例随访3～12个月，阴茎外观均接近正常，无下弯。尿道开口于阴茎头部，排尿通畅。结论：保留尿道板成形手术操作相对简单，易掌握，成功率高，适用于阴茎体型及阴茎下弯较轻的尿道下裂患者，对于尿道成形失败者也是一种非常有效的治疗方法。

Preservation of urethral plate in one-stage urethroplasty for hypospadias (Reports of 31 cases)

Objective:To evaluate the efficacy of urethral plate preserving procedures in hypospadias repair.Methods:31 children patients with hypospadias underwent one-stage urethroplasty. Of them, 14 patients received Mathieu repair, 7 Onlay island flap procedure and 10 Snodgrass procedure. All 31 patients presented with penile body type and mild curvature and 7 of them failed in the urethroplasty at the first time.Results:The overall successful rate was (90. 32)%. 2 cases were complicated with urinary fistula and 1 with urethral stricture. The follow-up of 3~12 months showed that all of patients micturated fluently with meatus located at the glans of penis of approximately normal shape.Conclusions:Preservation of the urethral plate is suitable for hypospadias with or without mild chordee and the procedure is easy to master with high success rate. In addition, the procedure could also be adopted effectively to such patients who have failed in the urethroplasty.