应用会阴不同部位皮肤再造尿道远期微环境对比研究

目的:观察应用不同部位皮肤再造尿道的远期微环境差异及与正常尿道的差别,探讨哪些部位来源的皮肤适合用于再造尿道。方法:应用尿道镜、尿道造影及术中直视下观察应用阴囊、阴茎、包皮等不同部位皮肤再造尿道的远期外观。应用光镜观察应用不同部位皮肤再造尿道内壁结构、正常皮肤(包括阴囊、阴茎、包皮等部位皮肤)结构、正常尿道黏膜结构,并对比其差异。结果:应用不同部位皮肤再造尿道的远期外观均可以接近正常尿道黏膜,但结构与同源皮肤完全相同。应用不同部位皮肤再造尿道的皮肤附属器检出率与同源皮肤相近,不同部位皮肤附属器检出率递增顺序依次为:包皮内外板、阴茎体、阴囊中隔、阴囊。结论:应用皮肤再造尿道的远期结构仍为同源皮肤。从微环境角度来说,会阴皮肤用于再造尿道的选择顺序依次为:包皮内外板、阴茎体、阴囊中隔、阴囊。

The comparing study of long-term microenvironment of reconstructed urethras made of skin from different body areas

Objective To observe the difference of microenvironment between normal urethra and the long term neo-urethra reconstructed with skin to explore which part of skin is more fit for urethra reconstruction. Methods The long-term neo-urethra reconstructed with scrotum,penis,and prepuce skin were observed during operation and through urography and urethroscope to compare the difference of appearance. The tissue section of normal urethra,scrotal skin,scorotal septum skin,penial skin,and preputial skin,and neo-urethra reconstructed with scrotum,penis,and prepuce skin were observed through light microscope to compare the difference of structure. Long term results of neo-urethra inner wall made of scrotum,penis,and prepuce skin were observed during operation and through urography and urethroscope. Skin appendages of the tissue section were compared at the same time. Results The long-term appearance of neo-urethra made of skin from different part of body was near to normal urethra. While the structure of neo-urethra was the same as skin from the same part of body,the appendages detection rate of neo-urethra was close to that of skin from the same part of body. The appendages detection rate of different part of skin increase as follows: prepuce,penis,scorotal septum and scrotum. Conclusion The long term structure of neo-urethra reconstructed with skin was the same as that of skin from the same part of body. Histologically,different part of perineum skin is recommended for urethra reconstruction in the order as follows: prepuce,penis,scorotal septum and scrotum.