会阴型尿道下裂Ⅰ期手术探讨

目的：报道I期治疗会阴型尿道下裂伴阴茎阴囊转位及阴囊分裂的一种方式，方法：自1996－1999年共收治会阴型尿道下裂伴阴茎阴囊转位及阴囊分裂，且包皮短缺的有8例，采用会阴部原位皮管（Duplay)加双阴囊内侧带蒂皮瓣一期成型尿道，术中行耳骨上膀胱造瘘引流尿液，经尿道置支架管，术后应用头孢米诺钠（80mg.kg^-1.d^-1)和灭滴灵（15mg.kg^-1.d^-1)1周，术后1周拔除支架管，2周拔除引流管，结果：7例I期成功，1例发生尿瘘，半年后经修补后痊愈，外观均满意，结论：此法应用解剖学的理论依据，对于复杂的尿道下裂有着外观功能均好的疗效，是一种较好的手术方式。

A new repair technique for complex proximal hypospadias

Objective To present a new technique for repair of proximal hypospadias with penoscrotal transposition and scrotal split.Methods Between December 1996 and December 1999, proximal hypospadias repairs were performed in 100 patients. Of them 8 patients with penoscroyal transposition and bifid scrotum were repaired with the new technique. We employed perineal flap(Duplay)and scrotal flaps to repair hypospadias in one stage in the 8 patients.Suprapubic diversion was used for drainage,and 8F or 10F tube was inserted to the proximal end of new urethra. Antibiotics(cefminox 80?mg/kg/d and metronidazole 15?mg/kg/d) were used after the operation on all of the patients for 7 days. Suprapubic tubes were removed 12 days after operation. Urethral tubes were removed 7 days after operation.Results One stage healing was achieved 7 patients.One patient suffered from fistula,was healed after reoperation six months later.Conclusions The techenique was theoretically based on the applied anatomy and the result of repair turned out to be satisfactory. We believe the techenique is a good alternotive for severe proximal hypospadias.