尿道下裂术后尿道狭窄的预防及再手术术式选择

目的：探讨尿道下裂术后尿道狭窄的预防及再手术术式选择。方法：对53例尿道下裂术后尿道狭窄病例的临床资料进行回顾性分析。结果：53例中获访45例，其中尿道外口狭窄或闭锁行尿道外口成形12例，8例治愈；26例单纯吻合口狭窄行狭窄段剖开、切除吻合或一期尿道重建，17例治愈；新尿道全部瘢痕狭窄行广泛切除一期尿道重建4例，2例治愈；尿道造瘘二期尿道重建3例，2例治愈。结论：尿道狭窄是尿道下裂术后严重的并发症，关键在于预防，应根据不同的情况选择合理的治疗方法。

Prevention and treatment of serious complications after hypospadias surgery

Objective:To study the prevention and management of urethral strictures after hypospadias repair.Method:From January 1992 to October 2002, we accepted 155 cases of complications after hypospadias surgery, 53 cases of urethral strictures were retrospectively analyzed.Result:All the 45 cases were followed up. Of 12 meatal stenosis (including 6 cases with concomitant anastomotic strictures), 8 cases gained success; of 26 simple anastomotic strictures, which underwent urethrotomy and one-staged urethal reconstruction, 17 cases were cured; of 4 entire neourethral strictures, which underwent wide dissection and one-staged urethroplasty, 2 cases gained success; of 3 cases, which underwent urethrostomy and two staged urethroplasty, 2 were cured.Conclusion:Urethral stricture after hypospadias surgery is a serious complication and it is difficult to be treated. The key lies in prevention and to such patients a different method is choosed according to different conditions.