冻干脱细胞膀胱黏膜下基质在尿道下裂修复中的临床应用

目的在动物实验的基础上,将异体脱细胞膀胱黏膜下基质用于修复阴茎型尿道下裂患者,以初步了解其临床疗效。方法我们采用反复冻融—酶法获得了同种异体人脱细胞膀胱黏膜下基质,于2004年将其试用于3例尿道下裂患者的治疗。结果一期手术2例,尿线粗、直,无尿瘘,无散射;术后1年随访,阴茎无下弯,无尿痛、尿瘘,尿线粗,尿流测定仪及尿道镜检查未见异常。二期手术1例,远端尿道未见狭窄及闭锁。结论同种异体脱细胞膀胱黏膜下基质是一种有前途的较为理想的尿道组织修复替代材料,远期效果还有待继续进行严密仔细的观察。

The clinical application of acellular urinary bladder submucosa to reconstructive the urethral duct of hypospadias patients

Objective Attended to apply the acellular urinary bladder submucosa in the operation of the urethal duct reconstruction of penile hypospadias. Methods In 2 cases,the urethal ducts were reconstructed by using the acellullar urinary bladder submucosa as dorsal half of the urethra, while the preputial island flap as ventral side. In the other patient ,the urethral plate was incised ,similar to Snodgrass operation,the matrix was fixed to the corpora cavernosa beneath. Results Uroflowmetry and the urethroscopy were been performed in the one year follow up. A bell-shaped flow curve was obtained in the patient after urethroplasty using matrix graft combined with a local flap, and no fistula, stricture was found after a year or half a year follow-up. Conclusions The freeze-dried acellullar urinary bladder submucosa had three-dimensional network structure, and the acellullar urinary bladder submucosa graft combined with preputial flap for hypospadias repair provided satisfactory functional results.