改良Thiersch法正位尿道口尿道成形术

Modified Thiersch Urethroplasty for Hypospadias

目的 评价改良Thiersch手术治疗尿道下裂的疗效。 方法 对 18例已矫正阴茎下曲的尿道下裂病人 ,采用偏离中线的阴茎腹侧皮瓣 ,避免缝合线重叠 ;并利用包皮作皮瓣延伸 ,通过阴茎头内隧道 ,使尿道口达生理位。 结果 修复尿道长度 3～ 15cm。发生尿瘘 3例 ,尿道口狭窄 2例。一次手术成功率达 83 .3 %。 结论 改良Thiersch手术具有术式简单、手术成功率高、并发症少。

Objective To evaluate the therapeutic result of the modified Thiersch urethroplasty for hypospadias. Methods 18 Patients who had been corrected for penile curvature underwent hypospadias repair, by making an “off center” ventral penile skin flap, in other words, by mobilizing one side of the strip more than the other, in order to avoid overlapping suture lines. Meanwhile, a lateral penile skin flap was extended and rolled into a tube which was managed to tunnel through the glans forming an external meatus at the tip of the glans. Results The length of the reconstructed urethra was 3 15 cm. The success rate was 83.3%. There were 3 cases of fistulas and 2 cases of meatal stricture. Conclusion The modified Thiersch urethroplasty is characterized by satisfactory clinical results with simple performance, a higher success rate, less occurrence of complication and a better penis in shape.