邻近带蒂复合组织瓣修复复杂性前尿道狭窄12例

Repairing complex anterior urethral stricture with adjacent pedicle complex tissue flaps:report of 12 cases

目的：观察两种邻近带蒂复合组织皮瓣修复复杂性前尿道狭窄的效果。方法：对12例前尿道长段狭窄的男性患者,分别采用带蒂包皮瓣和带血管蒂阴囊纵隔组织瓣进行修复,并对其效果进行总结。结果：12例均顺利完成手术,一期愈合10例,排尿通畅,不需要多次尿道扩张,随访2~5年,无尿道再狭窄形成。1例发生尿瘘,再次修复治愈。1例舟状窝至尿道外口形成尿道下裂,不影响排尿。结论：邻近带蒂复合组织瓣修复复杂性前尿道狭窄具有取材方便、皮瓣血运好、愈合力强、再狭窄机会少等优点,是修复长段尿道狭窄首选的方法之一。

Objective：To observe the effects of two kinds of adjacent pedicle complex tissue flaps on the repair of serious long anterior urethral stricture.Methods：Preputial pedicle tissue flaps and vascularized scrotal septum pedicle flaps were applied to repairing serious long anterior urethral stricture,and the effects were evaluated.Results：The operation was successful in all the 12 cases.Ten cases healed at one stage with smooth urination and no need for urethral dilation.No urethral restenosis occurred during the follow-up of 2-5 years.Urethral fistula occurred in 1 case,which was healed by second repairing.Hypospadias between navicular fossa and urethra external orifice was formed in 1 case,which had no influence on urination.Conclusions：Adjacent pedicle complex tissue flaps have many advantages for repair of serious long anterior urethral stricture：the material is easy to obtain,the flap has a good blood circulation and the wound healed well,leaving less chance of forming restenosis.It is one of the choice methods for the repair of long urethral stricture.