阴囊纵隔带蒂皮管法Ⅰ期尿道成形术(附121例报告)

目的 介绍应用阴囊纵隔带蒂皮管法治疗儿童先天性尿道下裂的经验。方法 尿道下裂121例，手术矫正阴茎下弯后，于尿道口近端取宽1cm～1．5cm的带血管蒂皮瓣，包绕硅胶管用可吸收线连续缝合成新尿道。结果 手术121例，成功107例，成功率为(88．5％)。术后尿瘘14例，尿道狭窄5例，憩室3例，尿道内毛发2例，尿道内结石1例。结论 阴囊纵隔皮管法尿道成形术皮瓣血运好，易成活，成功率高，操作简单，容易掌握，适合于矫正阴茎下弯后尿道口位于阴茎根部或阴茎阴囊交界型尿道下裂。但术后阴茎外观不十分满意且有尿道长毛发和结石可能，故选用此法应综合多方面因素考虑。

Experience of Treatment of Congenital Hypospadias by Medline Scrotal Raphe Tube with Vascularized Pedicel Flap

Objective To introduce the experience of the children's congenital hypospadias treated by medline scrotal raphe tube with vascularizd pedicle urethroplasty. Methods 121cases with hypospadias and penis with residual chordee, Correcting the penis with residual chordee, and then taking the 1cm ~ 1.5cm wide pedicel flap near the urethral orifice, the construction of neouretha was achieved by the running suture of the flap round the silica ductule. Results Of 121 cases with operations, 107 cases were success, the success rate were 88.5%. After operations, there were 14 cases with urethrocutaneous fistula, 5cases with urethral stricture, 3 cases with di-verticulum, 2 case with hair in neourethra, 1 case with urethral calculus. Conclusions The flap with medline scrotal raphe has a good microcirculation and survival rate. The method has higher success rate, and it can be easily performed and grasped. The method is used to treat the hypospadias which has the urethral orifice locating on the root of the penis after correcting the residual chordee or has junction between scrotum and penis. But after operation, the appearance of penis is not satisfied and it has the possibility to cause hair in neourethra and lithogenesis urethra, so that, then application of the method to traet congenital hypospadias,we should comprehesively consider the multiple factors.