Snodgrass手术在治疗失败尿道下裂中的应用

Application of Snodgrass Urethroplasty for Failure Hypospadias Repairment

目的探讨尿道板纵切卷管尿道成形术(Snodgrass法)对治疗失败尿道下裂的临床疗效。方法回顾性分析广州军区总医院泌尿外科2002年3月-2011年4月接受Snodgrass法治疗的81例阴茎皮肤少的治疗失败尿道下裂患者的临床资料,并与36例同期应用Duplay尿道成形术修复的阴茎皮肤相对充裕的治疗失败尿道下裂患者进行比较。2种治疗方法均留置尿道U形支架管,U形支架管两端分别从会阴部尿道及尿道外口引出,均采用肉膜瓣覆盖成形尿道。结果随访6个月～2 a,应用Snodgrass手术治疗81例,成功65例(80.2%),术后并尿道瘘11例,尿道狭窄5例。Duplay尿道成形术治疗36例,成功29例(80.6%),术后并尿道瘘5例,尿道狭窄2例。2组手术成功率比较差异无统计学意义(P>0.05)。结论 Snodgrass手术用于儿童阴茎皮肤少的治疗失败尿道下裂的修复,可取得满意效果。

Abstract ： Objective To evaluate the clinical efficacy of Snodgrass urethroplasty for failure hypospadias repairment with narrow urethral plate. Methods Eighty - one patients of failure hypospadia repairment patients with narrow urethral plate treated with Snodgrass urethroplasty from Mar. 2002 to Apr. 2011 were reviewed. In the meantime, Duplay procedure was undertaken for other failure hypospadias repairment with enough penile skin （36 patients）. One hundred and seventeen patients had indwelled urethral U -shaped tubes and used dartos flap covering the new forming urethra. Results All patients were followed up from 6 months to 2 years. There were 65 patients cured（ 80.2% ） ,5 patients with urethral stricture and 11 patients with urethral fistula by using Snodgrass urethroplasty. There were 29 patients cured （80.6%） ,2 patients with urethral stricture and 5 patients with urethral fistula by using Duplay urethroplasty. The results of 2 groups showed no obvious difference （ P 〉 O. 05 ）. Conclusion Snod^rass urethronlastv is versatile to failed hvnosnadias natients with insuffici^nt lncal tissues