保留尿道板、带蒂鞘膜补片纠治儿童阴茎下弯

Using Tunica Vaginalis Graft with Preservation of the Urethral Plate in Situ for Treatment of Penile Curvature

目的:探讨中重度尿道下裂合并的阴茎下弯的纠治方法。方法:回顾2008年5月～2009年11月本院对20例合伴中重度阴茎下弯的尿道下裂患儿施行了分期手术,第一期阴茎伸直术采用了保留原位尿道板、转移带蒂睾丸鞘膜补片法。结果:20例均成功实施手术,术后无皮瓣坏死、感染及渗血情况。有14例半年后施行第二期尿道成形术,术中经人工勃起试验评估阴茎弯曲纠正好。结论:保留尿道板、带蒂睾丸鞘膜补片法是一种纠治阴茎下弯的可靠方法,疗效满意。

Objective：Correcting penile curvature is an essential step in proximal hypospadias surgery. We introduce a technique using tunica vaginalis graft with preservation of the original urethral plate in situ for correcting penile ventral curvature with proximal hypospadias. Methods：From 2008 to 2009, twenty boys with proximal hypospadias and severe penile curvature were treated with curvature correction as the first stage of planned two--stage repair. We used tunica vaginalis graft （with processus as vascular pedicel） as a ventral corporal patch, without transetting urethral plate. Results：Postoperative complications were mild. Six months later, 14 boys were treated with tabularized incised plate urethroplasty as the second stage repair. No penile curvature was detected by artificial erection test during the second operation. Conclusions：The technique of curvature correction by mobilization of tunica vaginalis graft with process as a ventral corporal patch and preservation of the urethral plate is safe and effective.