转移睾丸精索鞘膜修补尿道下裂术后尿瘘

Tunica Vaginalis of Testis and Spermatic Fascia:A Good Alternative for the Repair of Urethral Fistula Resulting from Hypospadias Operation

目的:探讨尿道下裂术后尿瘘的修复方法,总结手术经验,提高手术成功率。方法:收集本院从2002年9月至2008年12月46例尿道下裂术后尿瘘修补术患者的临床资料,平均年龄11.7岁(3～26岁),共52个瘘口,瘘口直径均小于5mm,其中阴茎体部25例,阴茎阴囊交界处12例,阴囊处9例,分别采用连续内翻缝合法修补20例,转移睾丸精索鞘膜修补26例。结果:连续内翻缝合法一次修补成功率为55%(11/20),加用转移睾丸精索鞘膜修补一次成功率为84.6%(22/26)。结论:在连续内翻缝合的基础上,加用转移睾丸精索鞘膜修补尿瘘有更高的成功率。

Objective ： To evaluate the methods of repairing urethral fistula resulting from hypospadias operation. Methods ： We analyzed the clinical data of 46 cases of surgical repair of urethral fistula resulting from hypospadias operation. The patients ranged in age from 3 to 26 （ mean 11.7 ） years. There were 52 fistulas in all, with the diameters of less than 5 mm, of which 25 were in the midshaft of the penis, 12 in the penoscrotum, and 9 in the scrotum. Of the 46 cases, 20 were repaired by continuous knock suture and 26 by tunica vaginalis of testis and spermatic fascia. Results： The one-stage success rate of continuous knock suture repair was 55% （ 11/20 ） and that of the combined use of continuous knock suture with tunica vaginalis of testis and spermatic fascia repair was 84.6% （22/26）. Conclusion ： Based on continuous knock suture, the additional use of tunica vaginalis of testis and spermatic fascia yields a high success rate in repairing urethral fistula resulting from hypospadias operation.