弧形阴茎皮肤联合皮瓣I期治疗重度尿道下裂

目的报道弧形带蒂包皮内板阴茎背侧皮肤联合皮瓣治疗阴囊型及会阴型尿道下裂治疗体会。方法自2000年1月至2007年10月共收治阴囊型及会阴型尿道下裂12例，均采用弧形带蒂包皮内板阴茎背侧皮肤联合皮瓣（Ducrett＋Perovic’s）制成皮管I期成形修复尿道。术中常规耻骨上膀胱穿刺造瘘引流尿液，尿道置多侧孔硅胶管支架引流尿道，术后应用头孢曲松钠抗感染治疗，保留尿道支架管6—8d，膀胱造瘘管10～12d。结果11例I期成功，1例发生尿瘘，于6月后修补瘘管痊愈。排尿正常，无痛性勃起，阴茎无扭转，腹侧无臃肿。结论此法治疗包皮阴茎皮肤充裕之重度尿道下裂效果确切，外观满意，是一种较好的手术方式。

A Moditied Island Flap Technique For Repair Of Severe Hypospadias

Objective To present a moified technique of island flap （ Duckett ＋ Perovic＇ s method） for repair of severe proximal hypospadias. Methods Duning January 2001 and October 2007, severe proximal hypospadias repairs were performed in 12 cases by using Duckett＇ s method plus Perovic＇ s method. In all patients, we employed island flaps in one stage. Suprapubic diversion was used for drainage, and 10F or 12F tube was inserted to the proximal end of new urethra. Ceftriaxone was used after the operation on all of patients for one week. Urethral tubes were removed at 6 or 8 days after operation and the suprapubic tubes at 10 or 12 days after operation. Results One stage healing was successfully achieved in 11 patients. One patient suffered from fistula and were healed through re - operation at six months later. After the operation, normal function recovered and perfect appearance achieved. Conclusion The result of repair turned out to be satisfactory and we believe the technique is a good alternative for severe proximal hypospadias.