尿道板纵切卷管尿道成形在尿道下裂中的应用

Tubularized incised plate urethroplasty(Snodgrass procedure)in hypospadias repair

目的 总结尿道板纵切卷管尿道成形术 (Snodgrass法 )治疗尿道下裂的经验。 方法 对 43例尿道下裂患儿行Snodgrass尿道成形术 ,其中阴茎体型 35例 ,阴茎阴囊交界型 8例 ;9例为上次尿道成形失败者 ;10例阴茎下弯者先行阴茎背侧折叠 ;患儿尿道置管 10d ,拔管后常规前尿道扩张。 结果 43例随访 4～ 11个月 ,阴茎外观正常 ,无下弯 ;尿道开口于阴茎头前端 ,呈纵行裂隙状 ,排尿通畅 ,无尿道狭窄 ;术后 5例发生尿瘘 ,4例已做修补 ,均成功。 结论 Snodgrass尿道成形术可应用于近、远端型及有阴茎下弯的尿道下裂患儿 。

Objective To present the experiences in using the tubularized incised plate urethroplasty (Sondgrass procedure) for hypospadias repair. Methods Tubularized incised plate urethroplasty was performed for 43 cases of hypospadias including 35 distal penile shaft and 8 penoscrotal hypospadias.9 children have had a history of failed urethroplasty.Dorsal plication was carried out for 10 chordees.Bladder drainage was maitained for 10 days.After withdrawing the drainage,regular urethral dilatation was conducted. Results The patients have been followed up for 4～11 months and a good functional neourethra with a vertical slit like meatus was observed.There has been no chordee or stricture.5 patients had urethro cutaneous fistula,4 have been corrected. Conclusions Tubularized incised plate urethroplasty can be used in distal and proximal hypospadias repair including those with chordee and is especially indicated for patients without enough penile skin after failed urethroplasty.