游离包皮内板及膀胱黏膜尿道成形术治疗尿道下裂58例

Free Prepuce or Bladder Mucosa in One Stage Repairing Hypospadias for 58 Patients

【目的】探讨游离体(游离包皮内板及膀胱黏膜)治疗尿道下裂的疗效。【方法】本组58例尿道下裂患者:阴茎型尿道下裂47例;阴茎阴囊型9例;会阴型2例。47例采用游离包皮内板尿道成形术;11例采用膀胱黏膜尿道成形。【结果】上述两种方法手术时间平均为(4±0.9)h,游离包皮内板42例Ⅰ期修复成功率为89.3%(42/47),5例出现尿瘘;膀胱黏膜尿道成形Ⅰ期修复成功率为90.9%(10/11),1例出现尿瘘,1例出现尿道憩室。6例尿瘘均于3个月后一次修补治愈。尿道憩室经憩室切除及尿道修补术后治愈。【结论】游离包皮内板或膀胱黏膜修复尿道下裂具有取材方便,外形美观,治愈率高等优点,是治疗各型尿道下裂较为理想的方法。

[Objective]To study free prepue or bladder mucosa in the treatment of hypospadias. [Methods] In 58 cases,47 patients were penile hypospadias; 9 patients were scrotal hypospadias; 2 patients were perineal hypospadias. Forty-seven cases were treated with free prepuce and 11 cases with bladder mucosa graft urethroplasty . [Results]The average operation time of the two methods was （4±0.9） h, 42 cases were repaired with prepuce graft urethroplasty,Success rate was 89.3%, 5 cases developed urethral fistulae; 10 cases were repaired with bladder mucosa urethroplasty success rate was 90.9% ,one developed urethral fistula, and one developed urethral diverticulum. All patients with urethral fistulae were repaired after 3 months. The patient with urethral diverticulum was cured with diverticulum excision and urethroplasty. [Conclusion]The operation has many advantages such as easy for taking tissue ,having beautiful shape and high cure rate. In a word, the operation of using free prepuce or bladder mucosa in the treatment of hypospadias can attain satisfactory curative effect on most cases.