膀胱粘膜尿道成形术治疗复杂性尿道下裂

The study of bladder mucosa grafting urethroplasty for the treatment of complex hypospadias

目的对膀胱粘膜尿道成形术治疗复杂性尿道下裂的手术中适应证及手术方法进行讨论,以重新认识其应用价值。方法总结1996-2006年经多次手术失败的复杂性尿道下裂11例,平均尿道缺损4.5 cm,采用改进后的膀胱粘膜尿道成形术I期尿道成形。结果术后均获得满意的疗效,阴茎伸直满意,外形好,尿线粗,开口正常位置。1例术后尿道外口狭窄,经扩张治愈。手术一次成功率90.9%。结论对多次手术失败、阴茎疤痕严重、局部取材困难、尿道缺损过长的复杂尿道下裂的病例,采用膀胱粘膜尿道成形术I期尿道成形仍是目前合理、有效的手术方法。

Objective： To discuss the improvement of operative techniques and to select the suitable cases for bladder mucosa grafting urethroplasty in one-stage repair of hypospadias.Methods： Eleven operation failure cases with complicated hypospadias were reviewed from 1996-2006.The average length of urethra defect was 4.5cm.One-stage urethra was shaped with the improved bladder mucosa grafting urethroplasty.Results： The satisfying treatment was achieved after the operation.All penises were straightened forward well and had good appearance.The urinary streams were normal.Each new urethral meatus was in right position.The voiding function recovered well in one patient with urethral stricture after periodic dilatation of the urethra.The successful rate of one-stage operation was 90.9%.Conclusion： The one-stage bladder mucosa grafting urethroplasty is feasible and is especially valuable for those complex hypospadias with the scar of penis is hard,having difficulties in drawing local materials or the defect of urethra is too long.