自制多孔平行双支架管在尿道下裂手术中的应用

目的 探讨提高各型尿道下裂修复手术成功率的方法.方法 220例尿道下裂患者,均采用一期尿道成形术.阴茎伸直后,用带蒂包皮内板尿道成形术(Duckett术)195例;阴囊中隔+带蒂包皮内板联合成形术20例;膀胱黏膜游离移植尿道成形术5例.用自制带有多个侧孔的平行双硅胶管作为尿道下裂修复手术中新形成的尿道支架管.结果 术后随访1～8年,208例一期手术成功,排尿通畅;2例术后出现尿瘘;6例手术1个月后出现尿道吻合口狭窄,4例术后1个月尿道外口狭窄.结论 本组一期手术成功率达94.5%,自制带有多侧孔的平行双硅胶管作为尿道支架管,具有通畅引流、利于冲洗等优点,可减少感染、尿瘘、狭窄的发生率.

Application of self-made dual tubes with lateral holes in the surgical treatment of hypospadias

OBJECTIVE: To increase the success rate of surgical treatment in patients with hypospadias. METHODS: 220 cases of hypospadias underwent one-stage urethra plasty. After the penis was straightened, urethra plasty was performed with pediculated preputial entoplastron (Duckett's method) in 195 cases; with combination of scorotal septum and pediculated preputial entoplastron in 20 cases; with free bladder mucosa transplantation in 2 cases. The self-made dual silastic tubes with lateral mini-holes were applied to support new urethra in all the cases. RESULTS: The patients were followed up for 1 - 8 years. 208 cases achieved successful results. There were 2 cases of urethral fistula, 6 cases of urethral stenosis at anastomosis site, 4 cases of stenosis at urethral orifice. CONCLUSIONS: The success rate (94.5%) suggests great advantages of the self-made dual tube with lateral mini-holes to support new urethra. It can facilitate drainage and irrigation and reduce the complications such as infection, fistula and stenosis.