尿道下裂不同术式的疗效评价

目的 评价尿道下裂不同成形术式的疗效。方法 总结434例尿道下裂手术资料，分析不同术式与尿道狭窄及尿道瘘的发生率。结果 尿道口前移、阴茎头成形术（MAGP1）和Onlay island flap法（加岛状皮瓣法）的狭窄、尿道瘘发生率为零；Flip-Flap法的狭窄发生率为9％，尿道瘘发生率为5％；Dennis-Brown的狭窄、尿道瘘发生率分别为28％和28％；膀胱膜法的狭窄和尿道瘘发生率分别为36％和4％。结论 阴茎头、冠状沟型尿道下裂宜采用MAGPI法，阴茎体型宜采用Flip-Flap法，近端型宜用加盖岛状皮瓣法或Duplay Duckett法，仅在材料缺乏时才考虑膀胱粘膜法。

Evaluation of various procedures for the repair of hypospadias

Objective To evaluate the different procedures for the repair of hypospadias. Methods From 1987 to 1997,434 patients underwent hypospaidas repair.The postoprative stricture rate and fistula rate of each procedure were studied. Results Of the 434 cases,postoperative urethral stricture developed in 50 and fistula in 32.The postoperative stricture rate and fistula rate for MAGPI were both 0%;both were 0% too for Onlay island flap procedure;these were 9% and 5% for Flip Flap's operation,28% and 28% for Dennis Brown's procedure,36% and 4% for bladder mucosa flap procedure. Conclusions MAGPI is recommended for glandular and coronal hypospadias and Flip Flap's operation for penile hypospadias.When the above mentioned approaches are not feasible,Onlay island flap procedure or Duplay and Duckett's operation are recommended.