睾丸精索鞘膜在治疗尿道下裂及尿瘘修补术中的应用

Application of Tunica Vaginalis of Testis and Spermatic Cord in Treatment of Hypospadias and Urethral Fistula

目的:探讨睾丸精索鞘膜在治疗尿道下裂及尿瘘修补术中的应用和优势,总结手术经验,提高手术成功率。方法:本文总结了2002年12月～2010年12月共35例背侧包皮肉膜组织缺乏、不足够覆盖成形尿道的患儿,采用Snodgrass手术加转睾丸鞘膜及精索鞘膜瓣治疗尿道下裂;26例瘘口直径小于5mm,位置在阴茎体部或阴茎阴囊交界处或阴囊部26例的尿瘘患儿,采用转移睾丸精索鞘膜修补术。结果:35例一次手术成功30例。成功率85.7%(30/35)。连续内翻缝合加用转移睾丸精索鞘膜修补一次成功率为84.6%(22/26)。结论:在新成形尿道或尿瘘修补口处加盖转移睾丸精索鞘膜更高的成功率。

Objective To study the application and advantages of tunica vaginalis of testis and spermatie cord in treatment of hypospadias and urethral fistula, summarize the surgical experience, and improve the success rate of surgery. Methods From December 2002 to December 2010,35 children who is lack of the dorsal package skin membrane, not enough to cover and forming a complete urethral were treated with snodgrass surgical method using tunica vaginalis of testis fascia or spermatic fascia. 26 cases of children with fistula diameter less than 5mm, fistula position in the penis body, the penis scrotal junction or scrotal, were repaired ferred tunica vaginalis of testis and spermatic cord. Results Success rate after first stage was 85.7% （ by trans30/35）.The success rate of continuous knock suture combined transferred tunica vaginalis of testis a/adspe-rmatic cord was 84.6% （22/26）. Conclusion The use of tunica vaginalis of testis and spermatic cord yield a higher success rate in forming a new urethra and repairing urethral fistula.