隧道式膀胱粘膜移植尿道成形术(附50例临床报告)

Urethroplasty with Transplantation of Bladder Mucosa in Tunnel

目的 提供一种治疗尿道下裂的新手术方法 ,可以提高膀胱粘膜尿道的成活率 ,减少尿道瘘的发生。方法 对 4 5岁～ 16岁共 50例尿道下裂患儿采取分期手术 ,Ⅰ期矫正阴茎弯曲 ,术后应用绒毛促性腺激素治疗。待阴茎体发育充分后进行Ⅱ期隧道式膀胱粘膜移植尿道成形术。结果 50例术后患儿移植的膀胱粘膜尿道全部成活 ,尿道瘘的发生率明显低于其它术式。阴茎外观接近正常 ,尿道可以达到正位开口。

Objective To provide a new operative method to treat hypospadias that can increase survival rate of bladder-urethral mucosa and reduce the complications of urethral fistula. Methods 50 cases of hypospadias patients aged from 4.5～16 year-old were operated in installments. The penis curve was corrected in Ⅰ stage and treated with HCG after operation. Urethroplasty with transplantation of bladder mucosa in tunnel was taken after penis developed well in Ⅱ stage. Results All bladder-urethral mucosa of 50 cases was survived after operation. The occurrence of urethral fistula was obviously lower than those of other operations. The outlook of penis was nearly normal and the orifice of urethra could be right position. Conclusion The advantage of this method compared with open operation might be decreasing the occurrence of urethral fistula.