Snodgrass尿道成形术治疗尿道下裂

目的 总结Snodgrass尿道成形术治疗尿道下裂的适应症及方法，并评价其疗效。方法 回顾性分析66例尿道下裂病人行Snodgrass尿道成形术。冠状沟型25例，阴茎体型30例，阴茎阴囊型9例，会阴型2例。其中20例为尿道成形失败者，45例合并阴茎下弯畸形先行阴茎背侧折叠。留置导尿管平均12天，拔管后常规扩张前尿道4—6周。结果 术后随访6个月—2年，一次手术成功52例，阴茎外观正常，无下弯畸形，尿道开口位于阴茎头前端，呈纵行裂隙状。发生尿道瘘14例，经尿道扩张后自愈2例，再次采用该术式成功4例。结论 Snodgrass尿道成形术可应用于各型尿道下裂及有阴茎下弯的病人，且操作简便，手术成功率高，易于掌握及推广。对尿道成形失败而皮肤所剩极少的病人也是一个良好的手术方法。

The clinical experlance of Snodgrass urthroplasty

ObjectiveTo detect the proper indication a nd methods,evaluate therapeutic of urethroplasy(Snodgrass procedure)for hypos padias repair.MethodsTubularized incised plate urethropl asty was performed for 66 cases of hypospadias incloding 25 coronal,30 glandular ,8 penoscrotal and 2 perineal hypospadias.20 children have had a history of fail ed urethroplasty.Dorsal plication wascarried out for 45 chordees.Bladder drainag e was maintained for 12 days.After withdrawing the drainage,regular urethral di latation was conducted.ResultsThe patients had been fol lowed up for 6 months-2 years and a good functional neourethra with a vertical slit-like meatus was observed.There had been no chordee or stricture.14 patient s had urethrocutaneous fistula,4 have had corrected with Snodgrass,2 had been c orrected with urethral dilatation.ConclusionTabularized incised plate urethroplasty(sondgrass procedure) is a easy method and is especi ally indication for patients without enough penile skin after failing urethropla sty.The success rate of sondgrass procedure is high.