横行带蒂包皮瓣尿道成形术治疗尿道下裂

Transverse preputial island flap urethroplasty for hypospadias

目的探讨横行带蒂包皮瓣尿道成形术(Duckett)治疗尿道下裂的效果。方法采用Duckett术一期成形修复尿道下裂35例,I度(阴茎头、冠状沟型)4例,Ⅱ度(阴茎体型)26例,Ⅲ度(阴茎阴囊型)3例,Ⅳ度(会阴型)2例。其中2例Ⅳ度病例行Duckett加Dupaly术。结果一次性治愈27例,术后出现尿瘘6例,尿道狭窄2例,均经再次手术治愈。随访29例,时间1/2-3年排尿正常。结论Duckett术式成形的尿道顺应性好,管腔宽,血供较好。本术式是修复I-Ⅳ度尿道下裂的较为理想术式。

Objective To study the effect of transverse preputial island flap urethroplasty（Duckett＇s operation）on hypospadias. Methods Dukett＇s operation was used to repair hypospadias in 35 patients. Results Thirty-five patients with hypospadias （4 cases of glanz and subcoronal type,26 penile,3 penoscmtal,2 pefineal）were treated by Duckett＇s operation. Of them, the Duckett＇ s and Dupaly＇s operation were made simutaneously in 2 patients with hypospadias. Uninary fistula occurred in 6 patients（6/35） and urethro stenosis in 2 patients（2/35）. Conclusions The preputial flap is an ideal material for urethoplasty with many advantages and Duckett＇s procedure can attain satisfactory curative effect.