尿道下裂术后尿道狭窄与术式选择的关系研究

目的研究尿道下裂术后尿道狭窄与术式选择之间的关系。方法总结1995年6月至2005年6月经本院治疗的324例尿道下裂尿道成形术病例资料,发现术后合并尿道狭窄43例,分析不同术式、狭窄发生部位与狭窄发生率之间的关系。结果尿道口前移龟头成形术(MAGPI),加盖岛状皮瓣法(OnlayIslandFlap)的尿道狭窄发生率为0%,Mathieu法的尿道狭窄发生率为9.4%。而Dennis-Brown法与膀胱粘膜法的尿道狭窄发生率较高,分别为28.3%、40.0%。结论对于阴茎头、冠状沟型尿道下裂应尽量采用MAGPI法;阴茎体型尿道下裂宜采用Mathieu法;而近端型尿道下裂宜采用OnlayIslandFlap或Duplay Duckett法;只有当没有或缺少材料时才考虑采用膀胱粘膜法。

Selection of Hypospadias Repair Approach And Urethral Stricture

Objective To evaluate the stricture rates of different hypospadias repair approaches. Methods Clinical data of 324 patients who underwent hypospadias repair between Jun 1995 to Jun 2005 were summarized, 43 of them developed urethral stricture.The stricture rate of each surgical approach was analyzed. Results The stricture rates of MAGPI, onlay island flap,Mathieu's operation, Dennis-Brown's procedure and bladder mucosa flap were 0%, 9.4%, 28.3% and 40% respectively. Conclusions MAGPI shuld be recommended for glandular and coronal hypospadias .Mathieu's operation is recommended for penile hypospadias. Onlay island flap or Duplay and Duckett's operation are recommended for proximal hypospadias. Bladder mucosal flap should be considered if without or lack materials.