带蒂阴囊正中皮瓣一期尿道下裂成形术的疗效分析

目的:总结带蒂阴囊正中皮瓣一期治疗各型尿道下裂的经验,提高一期治疗尿道下裂疗效。方法:回顾分析本科室1993年5月至2010年12月收治310例各型(除冠状沟型)采用该术式治疗尿道下裂患者的临床资料,所有病例均随访6个月至2年。结果:310例尿道下裂患者,手术治愈271例,治愈率为87.4%(271/310),术后尿道发生尿屡39例,尿瘘发生率为12.6%,无其他并发症发生。术后尿瘘形成与尿道下裂分型、术后综合用药与否及成形皮管长度等因素有关,而与支架管留置时间无关。尿瘘患者瘘口多位于阴茎根部。结论:对于除冠状沟型外的各型尿道下裂,该术式均是一种疗效可靠且简单易行的治疗方案,同时其术后处理也非常重要。

One-stage urethroplasty with pedicled scrotal skin flap for hypospadias

Objective: To summarize the experience in one-stage urethroplasty with pedicled scrotal skin flap for hypospadias,and improve its therapeutic effect.Methods: We retrospectively analyzed the clinical data of 310 cases of hypospadias(except coronal hypospadias) treated by one-stage urethroplasty with pedicled scrotal skin flap.All the patients were followed up for 6 to 24 months.Results: No postoperative complications were observed except urinary fistula,which occurred in 12.6% of the patients.Postoperative fistula formation was associated with the type of hypospadias,the length of the urethral defect and postoperative comprehensive medication,but not with the stent indwelling time after surgery.Most of the fistulae were located at the base of the penis.Conclusion: One-stage urethroplasty with pedicled scrotal skin flap is a simple and effective option for all types of hypospadias except the coronal type,and postoperative treatment is very important.Natl J Androl,2012,18(9): 816-818