带蒂包皮双面皮瓣法联合DuplayⅠ期修复重度尿道下裂

A study of one-stage repair using pedicled preputial double-faced island flap combining with Duplay ure- throplasty on severe hypospadias

目的总结带蒂包皮双面皮瓣法（PPDIF）联合原位尿道板卷管（Duplay）治疗重度尿道下裂的方法及疗效。方法1998年1月至2010年3月采用带蒂包皮双面皮瓣法加原位近端尿道板卷管（PPDIF＋Duplay）术式治疗重度尿道下裂72例，包括阴囊型50例，会阴型22例。结果平均随访23个月，术后阴茎伸直及外观满意，尿道口位置正常。发生尿瘘10例（13．9％），尿道狭窄4例（5．6％），手术总成功率达80．6％。结论PPDIF联合Duplay术式Ⅰ期修复重度尿道下裂疗效肯定，具有术后外形美观，尿道狭窄、尿瘘等并发症少等优点。

Objective To retrospectively summarize the clinical application and efficacy of the Pedicled preputial double-faced island flap （PPDIF） combining with Duplay procedure in patients with severe hypospadias. Methods From January 1998 to March 2010, 72 children （ranging from 10M to 12Y, mean age 4. 1 years） with severe hypospadias underwent one-stage urethroplasty by using PPDIF combining with Duplay procedure, which included 50 scrotal type patients and 22 perineal type patients. Results The mean follow-up time was 23 months. The straightening and outlook of the penis were satisfactory, and the meatus located at normal anatomical position after operation. 10 cases （13. 9 %） were complicated with fistula and 4 （5.6 % ） were complicated with urethral stenosis after operation. 80. 6% of patients get the better curative efficacy. Conclusions PPDIF combining with Duplay procedure is better approach to treat severe hypospadias. It can bring the benefits to patients involving better cosmesis, less urethral stenosis and fistula incidence.