加盖带蒂包皮瓣一期尿道成形术修复小儿尿道下裂

目的：探讨加盖带蒂包皮瓣Ⅰ期尿道成形术修复小儿尿道下裂的手术要点和临床效果，提高手术技巧。方法对50例小儿尿道下裂应用onlay island flap术式（横裁带蒂岛状包皮瓣加盖法）行一期尿道成形手术。观察阴茎伸直和尿瘘、尿道狭窄的发生情况，总结和完善手术技巧。结果50例手术患儿获随访3个月至2年，均阴茎伸直满意，尿道位于龟头前端开口，外观良好。44例尿道下裂一次性手术成功，4例发生尿瘘；2例发生尿道外口狭窄，行尿道扩张后痊愈。结论加盖带蒂包皮瓣Ⅰ期尿道成形术修复小儿尿道下裂符合解剖生理，术后阴茎外形美观，并发症少，是一种修复阴茎下弯较轻的尿道下裂的理想术式。手术成功的关键在于保护皮瓣血管蒂的血供，掌握合理的尿道板皮条和岛状包皮瓣宽度及娴熟的缝合技巧。

One-stage urethroplasty repair with onlay preputial island flap for pediatric hypospadias

Objetive To investigate the operation methods and clinical efficacy of onlay preputial island flap urethroplasty in treatment of pediatric hypospadias. Methods Fifty patients with hypospadias were includ-ed in this study.Neourethra was formed with onlay preputial island flap and urethral plate.Post-operative cos-metic appearance of penis and rate of Fistula and urethral stricture were observed. Results All patients were followed up for 3 months to 2 years.44 cases were successfully treated for one-stage.Good post-operative cos-metic appearance of penis was achieved in all of 50 patients.4 cases supervened with urinary fistula,2cases with meatal stenosis. Conclusion Onlay preputial island flap urethroplasty has good effect in treatment of proximal and distal hypospadias.The technique was based on the anatomy.Good skin bloodstream,width of preputial flap and urethral plate,are most important to elevate the therapeutic effect.