尿道下裂术后尿瘘原因及修补体会

Realization of the Reason and Restoration of Urethrorrhea after Hypospadias Repair

目的 探讨各型尿道下裂术后尿瘘发生原因及修补方法。方法小尿瘘采用结扎法,切开缝合法,皮瓣覆盖法修复,大尿瘘采用Thiersch法或重新行尿道成形术。 结果 123例尿道下裂术后29例出现尿瘘(23.58％)。尿瘘发生后立即修复的成功率(3/9,33.33％)远低于尿瘘发生半年后修复的成功率(14/17,82.35％)。3例半年内自行愈合。结论尿瘘的发生与尿道成形材料,局部血运及创面感染有关,与术式本身关系不大。瘘口大小、术式选择、修补时间是尿瘘修补成功的关键。

Objective To discuss the cause and repiring method of urethrorrhea after different types of hypospadias repairs. Methods A small urethrorrheas adopted ligation, incised suture, skin flap covering repairing mehod, and big ones adopted Thiersch technique or again ure-throplasty. Results 29 of 123 cases had occurred urethrorrhea (23.5%) after hypospadias repair. And for such patients, the successful rate of immediate repair(33.33%) was significantly lower than those of repair at half a year after the urethrorrhea occurrence(83.23%), 3 cases were healed without treatment at within 6 months. Conclusions Occerrence of urethrorrhea is related to material used,partial circulation and infection of wound area,but has little to do with the type of operation itself..And three factors,including size of urethrorrhea,choice of operation,repairing time are keys for a successful reparation.