阴囊中缝皮瓣联合矩形包皮内板皮瓣治疗阴茎阴囊型尿道下裂疗效观察

目的观察阴囊中缝皮瓣联合矩形包皮内板皮瓣治疗阴茎阴囊型尿道下裂的临床疗效。方法我科2004年3月—2010年12月32例阴茎阴囊型尿道下裂患者均采用阴囊中缝皮瓣联合矩形包皮内板皮瓣Ⅰ期尿道成形治疗,对术后的愈合情况及尿瘘、皮瓣坏死发生情况进行观察、记录。结果本组患者均成功施行阴茎伸直及尿道成形术,32例患者尿道皮瓣完全成活,无一例发生坏死,阴茎完全伸直。发生尿漏4例,尿道狭窄1例,阴茎轻度扭转1例。4例尿漏患者均于6个月～1年行尿瘘修补术后愈合;1例尿道狭窄患者行尿道扩张后痊愈;1例阴茎轻度扭转,未行特殊处理,1年后复查外观接近正常。结论阴囊中缝皮瓣联合矩形包皮内板皮瓣治疗阴茎阴囊型尿道下裂,可有效减少尿瘘发生率,皮瓣成活率高,具有较好的临床应用和推广价值。

Efficacy of Scrotal Raphe Flap,Rectangular Prepuce Flap Combined Treatment of Penile Scrotal Hypospadias

Objective To investigate the clinical efficacy of combined treatment of scrotal raphe flap and rectangular prepuce flap in treating penile scrotal hypospadias.Methods 32 penile scrotal hypospadias patients who admitted to our department from March 2004 to December 2010 were given combined treatment of scrotal raphe flap and rectangular prepuce flap.The therapeutic effect,urinary fistula and necrosis of the flap were observed and recorded.Results All patients had successful implementation of penis straightening and urethroplasty.Urethral flap survived completely in 32 patients whose penis could fully extend,and no necrosis was found.Urine leakage was found in 4 cases,urethral stenosis was found in 1 case,mild penile torsion in 1 case.Urine leakage was cured in the 4 patients by urinary fistula repairing after six months to one year.Urethral stenosis was cured by urethral dilatation and the mild penile torsion wasn′t given any special treatment.Review after one year showed near-normal appearance.Conclusion Scrotal raphe flap,rectangular prepuce flap combined treatment of penile scrotal hypospadias can effectively reduce the incidence of urinary fistula with high survival rate of skin tube.It has good clinical value and promotion value.