小阴唇皮肤粘膜组织瓣再造尿道临床体会

Clinical experience of the urethral reconstruction with labia mucosa tissue flap

目的：摸索在易性病及两性畸形患者性器官再造时尿道再造提升的方法。方法：在左右小阴唇皮肤粘膜组织上设计横行方向蒂在内侧粘膜面上的皮肤粘膜组织瓣,皮肤粘膜瓣蒂宽1.2~1.5cm,长4~6cm,左右两组织瓣对位缝合形成管状作为提升尿道,并将皮肤粘膜瓣通过皮下隧道固定于耻骨联合中点新尿道口位置。结果：36例阴唇皮肤粘膜组织瓣全部成活,提升尿道排尿顺畅,但有4例患者出现尿瘘并做了而期修补。结论：小阴唇皮肤粘膜组织瓣具有血运丰富、细薄柔嫩、无毛发等特点,是再造尿道时较为理想的组织材料。

Objective To explore the method of urethral reconstruction for transsexuals and sex deformity patients. Methods The skin minora flaps in the left and right labia minora were designed, pedicle of the flap was situated within labia minora and urethral meatus.Width of flap pedicle was 1.2-1.5cm,length of flap pedicle was 4-6 cm.Bilateral labia mucosa tissue flaps were stitched to form tubular flap as extended urethra.Through the subcutaneous tissue extended urethra was pulled up to the symphysis pubis.The new urethral opening was located at the symphysis pubis. Results 36 cases of labia mucous tissue flap all survived,the patients can easily urinate.Urethra fistula occured in the 4 cases and was repaired.No other postoperative complicationsother such as incision infection, urethra stenosis and postoperative hemorrhage occurred. Conclusion The labia mucous tissue flap has abundant blood supply and the characteristics of thinness,tenderness and hairless.It is a good tissue material for reconstructing urethra.