膀胱粘膜尿道成形术治疗复杂性尿道下裂

目的对膀胱粘膜尿道成形术治疗复杂性尿道下裂的适应证及手术方法进行讨论，以重新认识其应用价值。方法总结2002～2004年经多次手术失败的复杂性尿道下裂7例，平均尿道缺损5、7cm，采用改进后的膀胱粘膜尿道成形术Ⅰ划尿道成形的资料。结果术后均获得较为满意的疗效，阴茎伸直满意，外形好，尿线粗，开口近似正常位置。2例术后尿瘘，6个月后再次修补获成功，手术一次成功率71.4％。结论对多次手术失败、阴茎疤痕严重、局部取材困难、尿道缺损过长的复杂尿道下裂的病例，采用膀胱粘膜尿道成形术Ⅰ期尿道成形仍是目前合理、有效的手术方法。

Bladder mucosa grafting urethroplasty for complex hypospadias

Objectives To discuss the improvement of operative techniques and to select the suitable cases forbladder mucosa grafting in one-stage repair of hypospadias. Methods Reviewed the material of 7 patiens underwentone-stage bladder mucosa grafting urethroplasty. The average length of urethra defect was 5.7 cm. Results Theoperation was successful in 5 patients. All of the penis were straightened forward well and had good appearance. Theurinary streams was also good. Each new urethral meatus was in right position. Conclusion The one-stage bladdermucosa grafting urethroplasty is a feasible procedure and is especially valuable for those complex hypospadias whenthe scar of penis is hard, having difficulties in drawing local materials or the defect of urethra is too long.