改良脱套式修补法治疗尿道下裂术后尿瘘的疗效观察

目的:探讨改良包皮脱套式修补法在治疗尿道下裂术后并发尿瘘的疗效和应用价值。方法:回顾性总结2001年5月至2011年12月因尿道下裂修复术后并发尿道瘘而接受治疗的87例患者临床资料。其中61例患者采用简单缝合或者Y-V成形术(A组),而另外26例患者采用改良的包皮脱套式修补法(B组)。比较两组患者的手术成功率及远期复发情况。结果:A组有13例术后仍存在尿瘘,而B组仅有1例术后尿瘘复发,两组总体修复成功率分别为78.7%和96.2%。A组第二次手术后仍有6例失败,随后对6例患者运用包皮脱套式修补法修复成功;B组第二次手术修复成功。经过4.5年的随访两组患者中没有发现复发病例。结论:包皮脱套式修补法可以显著提高尿瘘修复的成功率,有临床推广价值。

Modified prepuce.degloving repair for urethrocutaneous fistula following hypospadias surgery

Objective： To investigate the clinical effect and application value of the modified method of prepuce-degloving re- pair （PDR） in the treatment of urethrocutaneous fistula （UCF） following hypospadias surgery. Methods： We retrospectively ana- lyzed 87 cases of UCF caused by hypospadias repair from May 2001 to December 2011, of which 61 were treated by simple closure or Y-V plasty of the fistula （ group A）, and the other 26 by modified PDR （ group B）. We compared the success rate of surgery and long- term recurrence between the two groups. Results ： The total success rates of repair were 78.7 and 96.2% in groups A and B, respec- tively. Thirteen cases in group A did not respond to surgery, of which 6 failed to be cured by the second operation but later were treated successfully by modified PDR. In comparison, there was only 1 case of failure in group B, which was cured by a second PDR. Con- clusion： Modified PDR can significantly improve the success rate and reduce the recurrence rate of UCF after hypospadias surgery, which deserves wide clinical application.