带蒂包皮双面皮瓣治疗小儿尿道下裂

目的 探讨带蒂包皮双面皮瓣尿道成形术(PPDIF)治疗小儿尿道下裂的适用范围和疗效.方法 尿道下裂患儿99例.年龄4个月～12岁,平均5.1岁.按Barcat分型:阴茎体型56例、阴茎阴囊型24例、阴囊型13例、会阴型6例.在Duckett术基础上,保留部分包皮外板皮肤连同成形尿道转移至腹侧,覆盖新生尿道. 结果 99例随访2年.术后发生尿瘘8例(8.1%)、尿道狭窄1例(1.0%)、皮瓣坏死1例(1.0%).手术总成功率89.9%(89/99).其中单纯应用PPDIF修复阴茎体型或阴茎阴囊型尿道下裂成功率91.2%(73/80),联合尿道口周围皮瓣(Duplay)术修复阴囊型或会阴型尿道下裂为84.2%(16/19). 结论 PPDIF适用于大多数小儿尿道下裂的治疗,术后外形美观.重度尿道下裂患儿联合Duplay矫正疗效肯定.

Pedicled preputial double-faced island flap urethroplasty for hypospadias in children

Objective To discuss the indication and efficacy for treating hypospadias with ure-throplasty of Pedicled preputial double-faced island flap(PPDIF). Methods Records of 99 children (mean age, 5.1 years; age range, 4 months-12 years)with hypospadias who underwent PPDIF oper-ation were reviewed. Of them, 56 cases were penile type of hypospadias, 24 cases of penile root type, 13 cases of scrotal type and 6 cases of perineal type according to Barcat classification. Based on Duck-ett technique, the partial preputial cortical plate remained and was displaced to gastr-penis with ure-thra. , and finally the new urethra would be covered by the cortical plate. Results During follow-up of average 2 years, 8 patients(8. 1%) developed urethral fistula, 1 (1.0 %) developed mild meatal ste-nosis, and 1(1.0 %) developed flap necrosis. The success rate for total PPDIF procedure was 89.90 % (89/99). And the success rate of simple PPDIF for cases with penile and penile root hypospadias, and PPDIF+Duplay for cases with serotal and perineal hypospadias were respectively 91.25 % (73/80) and 84.21%(16/19). respectively. Conclusions PPDIF is good for treating most hypospadias. Furth-more it make penis better shape. In the severe cases, PPDIF+Duplay prededure is recommended and the effect was affirmative.