应用大阴唇筋膜皮瓣行尿道远端重建九例临床分析

Reconstruction of distal urethra with labia majora fasciocutaneous flap in 9 cases

对9例行中远段尿道切除的患者，取双侧大阴唇内侧局部筋膜皮瓣经小阴唇下隧道穿人尿道切口，皮瓣对应长边缝合成管状与尿道断端吻合重建远端尿道。术后随访2年7个月-11年，除1例腺癌术后1个月内发生尿失禁、经盆底肌训练失禁症状消失外，其余均排尿正常。结果提示该手术方法对女性行中远端尿道重建创伤小、并发症少，且简便、安全、有效。

Nine female patients underwent resection of the middle and distal urethra and the urethra was reconstructed with labia majora fascioeutaneous flap. During the operation the bilateral inner side partial flap of labia majora was taken, and penetrated through the tunnel under the labia minora to the urethral incision, then the flap was sutured as tube-shaped and anastomosed with the urethral incision to reconstruct the urethra. Patients were followed-up for up to 11 years, all patients had normal urination, except 1 patient with adenoeareinoma who developed urinary incontinence I month after operation and recovered by pelvic floor muscle training. The application of labia majora fasciocutaneous flap is a safe and effective procedure with less trauma and fewer complications in reconstruction of female middle and distal urethra.