Y形阴囊皮瓣修复小儿重度尿道下裂12例报告

目的:探讨Y形阴囊皮瓣治疗小儿重度尿道下裂的适用范围和疗效。方法:背侧包皮不充裕的重度尿道下裂患儿12例,包括阴囊型7例,会阴型5例;合并阴茎阴囊不全转位11例,完全转位1例。年龄11个月～12岁,平均4.2岁。采用Y形阴囊皮瓣成形尿道并同期纠正阴茎阴囊转位。结果:平均随访2年,术后阴茎伸直及外观满意,尿道口位置正常。发生尿瘘4例(33.3%),尿道狭窄1例(8.3%),手术总成功率达58.3%。结论:Y形阴囊皮瓣适用于背侧包皮少的小儿重度尿道下裂的治疗,且能同期纠正阴茎阴囊转位,疗效肯定。

Y shape scrotal skin flap urethroplasty repair for severe hypospadias in children(Report of 12 cases)

Objective:To discuss the indication and efficacy for treating pediatric severe hypospadias with Y shape scrotal skin flap.Methods:From January 2000 to July 2010,severe hypospadias with the poorly developed dorsal foreskin in 12 boys were performed urethroplasty by Y shape scrotal skin flap and corrected penile-scrotal transposition at the same time.All patients had penile-scrotal transposition.Patient age ranged from 11 months to 12 years with an average age of 4.2 years.Of them,7 cases were scrotal type,5 cases of perineal type according to Barcat classification.Results:The mean follow-up time was 24 months.The straightening and outlook of the penis were basically satisfied,the meatus located at normal position after operation.Complications occurred in 5 patients(33.3%).Four patients(33.3%) experienced fistula.One(8.3%) suffered from urethral stenosis.Conclusions:Y shape scrotal skin flap urethroplasty offers a reliable repair for pediatric severe hypospadias with the poorly developed dorsal foreskin.Furthermore,penile-scrotal transposition can be corrected in the meantime.