尿道下裂手术15年回顾(附322例报告)

目的　探讨尿道下裂不同术式效果及特点。　方法　回顾 15年 32 2例尿道下裂手术资料 ,将术式分为原位皮瓣尿道成形、带蒂皮瓣尿道成形、游离组织尿道成形 ,观察手术效果。　结果　原位皮瓣尿道成形 :阴茎皮条埋藏尿道成形术 2 6例 ,成功 6 9.2 % ;阴茎皮管尿道成形术 33例 ,成功率 6 9.7%。带蒂皮瓣尿道成形 :带蒂阴囊皮瓣尿道成形术 146例 ,成功率 80 .8% ;横行带蒂包皮瓣尿道成形术 6 5例 ,成功率 81.5 %。游离组织尿道成形 :游离包皮瓣尿道成形术 9例 ,成功 7例 ;颊粘膜尿道成形术 1例 ,失败 ;膀胱粘膜尿道成形术 42例 ,成功率 88.1%。　结论　尿道下裂术式 ,各具优缺点 ,选取术式应综合多因素考虑。膀胱粘膜尿道成形术是目前成功率较高 ,合乎生理的术式

A review of operative treatment for 322 cases of hypospadias in the past 15 years

Objective To evaluate different operative procedures for hypospadias. Methods 322 cases of operatively treated hypospadias were reviewed.Orthotopic skin flap urethroplasty, pedicle skin flap urethroplasty and free tissue urethroplasty procedures were evaluated. Results In orthotopic skin flap urethroplasty,penile skin flap urethroplasty was undertaken in 26 with a satisfactory rate of 69.2%;33 cases underwent penilie skin tube urethroplasty with a success rate of 69.7%.In pedicle skin flap urethroplasty,146 underwent scrotum pedicle skin flap urethroplasty with a success rate of 80.8% and 65 underwent prepuce lamina pedicle skin flap urethroplasty with a success rate of 81.5%.In free tissue urethroplasty, free internal prepuce lamina urethroplasty was carried out in 9 with success in 7.One case underwent buccal mucosa urethroplasty has been a failure.Bladder mucosa graft urethroplasty was carried out in 42 with a success rate of 88.1%. Conclusions Many factors should be considered on choosing the operative procedure as each procedure has it own advantages and disadvantages.Bladder mucosa graft urethroplasty seems to render a higher success rate and the distensible characreistics of the mucosa approximate closer the normal urethra.