应用阴囊筋膜血管网皮瓣的尿道再修复

目的：探讨阴囊筋膜血管网皮瓣在尿道下裂再修复中的应用。方法：阴囊皮肤存在多源性血供系统，4组血管终末支相互吻合，形成完整的动脉环路在肉膜内走行，通过筋膜层滋养皮肤。基于此项解剖学基础，术中设计不含知名动脉的阴囊筋膜血管网皮瓣，用于修复原已采用阴囊纵隔皮瓣或其他轴型皮瓣进行尿道下裂矫治而失败的病例。结果：本组20例患者，阴茎型5例，阴茎阴囊型8例，阴囊型7例。除1例出现尿瘘，经处理后痊愈，19例尿道重建成功，效果满意。结论：应用阴囊筋膜血管网皮瓣重建尿道是尿道下裂再修复较为理想的方法。

Application of scrotal fascia vascular net flap on re-urethroplasty of hypospadias

Objective To introduce the clinical application of the scrotal fascia vascular net flap on re-urethroplasty of hypospadias. Methods There is a circular blood supply system in the scrotal skin, all 4 groups of arteries run in the scrotal dartos and its terminal branches anastomose with each other to form a integrated web through fascia. Based on the anatomic study, the scrotal fascia vascular net flap was designed and used on re-urethroplasty of hypospadias, which had prior failed repair with scrotal septal skin flap or other scrotal axial skin flaps. Results The flaps had all survived in total 20 cases, include 5 cases with type of penile and 8 cases with type of penile-scrotal, 7 cases with type of scrotal hypospadias. There was 2.5 years in average since the last failed procedure. There were no any complications in the most of cases, only 1 case had a urethral fistula. Conclusion Re-urethroplasty using scrotal fascia vascular net flap is ideal method for the failed hypospadias repair.