不同类型尿道下裂的手术方式选择

Selection of operation models for different kinds of hypospadias

目的提高尿道下裂矫正手术成功率。方法针对不同类型的尿道下裂在切口设计、阴茎头隧道建立及矫形、尿道成形材料选择、皮肤外覆等方面进行了一些改进与探索,共治疗69例尿道下裂。对临床资料进行分析总结。结果一期手术成功66例,成功率(66／69)95.65％。2例尿瘘,1例成形尿道裂开。结论手术矫正尿道下裂成功的关健是既要保证成形尿道的充足血供与营养,也要保证外覆皮肤的充分血供与活力,还要兼顾外生殖器的美观。要达到以上标准就应根据不同类型尿道下裂来选择不同的手术方式。

Objective To improve the success rate of hypospadias urethroplasty. Methods Some improvements of the incision design, construction of glans penis funnel,material choosing for urethroplasty and skin external application were carried out. The clinical data of 69 cases were summarized. Results 66 cases were succeeded in the first stage of operation, the rate is 95.65%(66/69). Urinary fistula appeared in 2 cases and cleavage of the new urethra happened in one. Conclusions The key to improve the success rate of hypospadias urethroplasty is to guarantee the sufficient blood supply of the new urethra and the applied skin,external genital beauty should be considered also. Different operation models should be chosen for different kinds of hypospadias accordingly.