二期膀胱黏膜尿道成形术治疗重型尿道下裂的评价

Evaluation of Two Stage Bladder Mucosa Urethroplasty for Severe Hypospadias

目的:对膀胱黏膜尿道成形术治疗重型尿道下裂的一期或二期手术疗效进行分析与评价。方法:对1998年1月～2007年10月采用一期或二期膀胱黏膜尿道成形术进行治疗的33例重型尿道下裂进行对照回顾分析。结果:一期膀胱黏膜尿道成形术18例,一次成功率55.6%(10/18),尿瘘发生率27.8%(5/18),外口狭窄发生率16.7%(3/18);二期膀胱黏膜尿道成形术15例,一次成功率66.7%(10/15),尿瘘发生率13.3%(2/15),外口狭窄发生率20.0%(3/15)。结论:结合临床观察及相关数据,二期膀胱黏膜尿道成形术在重型尿道下裂的治疗中似具有一定的优势,但尚需继续积累病例,通过有效的统计学分析进一步确证这一推论。

Objective：To evaluate and analyze the outcome of bladder mucosa urethroplasty in the treatment of severe hypospadias. Methods：33 cases of severe hypospadias treated with one/two-stage bladder mucosa urethroplasty were analyzed retrospectively from Jan. 1998 to Oct. 2007. Results：One-stage bladder mucosa urethroplasty was undertaken in 18 cases with a satisfactory rate of 55.6 % （10/18）, two stage bladder mucosa urethroplasty was undertaken in 10 cases with a satisfactory rate of 66.7%（10/15）. Urethral fistula occurred in 5 （27.8%） and 2 （13.3%） cases in one or two stage bladder nmcosa urethroplasty respectively, and stricture of urethral orifice occurred in 3 cases in both procedures （16.7 %, 20.0 % ）. Conclusions：On the basis of clinical phenomenon, we tend to consider two stage bladder mucosa urethroplasty as the better procedure for severe hypospadias and more clini cal data is needed to confirm this deduction.