儿童复杂性尿道狭窄的治疗

目的 探讨儿童复杂性尿道狭窄手术方法的选择及成功的关键。方法 25例复杂性尿道狭窄采用不同的手术方法治疗30次，其中采用口腔粘膜管状重建尿道3例。口腔粘膜补片尿道成形3例；经耻骨径路尿道端端吻合11例，膀胱壁瓣尿道成形2例；经会阴径路尿道端端吻合8例；双阴唇带蒂皮瓣Ⅰ期尿道成形2例；带蒂包皮内板Ⅰ期尿道成形1例。结果 术后随访2-36个月。平均18.5个月。一次手术后排尿通畅20例。术后效果不佳5例。经再次手术后排尿通畅4例。结论 儿童尿道狭窄手术方法的选择应根据尿道狭窄段的长短，位置选择合适的术式；口腔粘膜具有取材方便。创伤小，有较强的抗感染力的优点，是一种较好的尿道替代物。

The treatment of urethral stricture in children

Objective To evaluate the choice of operative procedures for the urethral stricture in children. Methods Twenty five patients with complicated urethral strictures underwent 30 different procedures. Of them buccal mucosa urethral reconstruction was performed on 6, trans pubic urethral reconstruction on 13, trans perineal urethral reconstruction on 8, one stage urethroplasty utilizing 2 pedicled flaps 2 and preputial island flap urethroplasty 1. Results The patients were followed up for 2 to 36 months (mean 18.5 months). Twenty patients passed urine well after first operation and 5 children had difficulties. Four of them improved after the second operation. Conclusions The choice of procedures for urethral strictures in children depends on length, location and severity of the stricture. Buccal mucosa is easy to obtain with little trauma to the patient and is highly resistant to infection. It is a good material for urethral substitution.