M形皮瓣法矫治尿道下裂术后残留阴茎阴囊转位44例效果分析

M-plasty for correction of residual penile and scrotum transposition after hypospadias repair surgery: Analysis of 44 cases

目的 探讨M形皮瓣法矫治尿道下裂术后残留阴茎阴囊转位的应用效果。方法 2010年10月至2014年7月我科采用M形皮瓣法矫治尿道下裂术后残留阴茎阴囊转位患者44例,阴茎阴囊转位采用以M形皮瓣法为主的矫形,阴茎背侧基底区皮肤明显凹陷者切除凹陷部位矩形皮肤,尿道缺损或憩室予以相应尿道修复重建。观察其临床效果。结果 术后随访14~63个月,平均29个月,失访3例,31例外观良好,阴茎阴囊位置关系正常,3例残留轻度阴茎阴囊转位,2例阴茎显露不良（其中1例阴茎发育不良）,6例并发尿道成形并发症（尿瘘3例次、尿道裂开2例次、尿道憩室2例次、尿道狭窄2例次）。结论 M形皮瓣法应用于尿道下裂术后残留阴茎阴囊转位可较好矫正阴茎与阴囊的异常位置关系,改善外观。

Objective To report the surgical outcome of M-plasty for correction of residual penoscrotal transposition after hy-pospadias repair .Methods From October 2010 to July 2014 ,44 patients with residual penoscrotal transposition after hypospadias re-pair were treated with M-plasty.In patients with significantly depressed dorsal penile base ,an additional rectangle skin was removed . Associated urethral defects or diverticulum were reconstructed simultaneously .Results Follow-up was performed from 14 to 63 months with an average of 29 months.Three patients were lost during follow-up.Good cosmesis was noted in 31 patients with normal penoscrotal position.Mild penoscrotal transposition was noted in 3 patients,and inconspicuous penis in 2 cease.There were 3 patients with urethro-plasty-related complications ,3 with urethral fistulas ,2 with urethral dehiscence ,2 with urethral diverticulum and 2 with urethral stric-ture.Conclusion M-plasty is applicable for residual penoscrotal transposition after hypospadias repair to correct the abnormal penos -crotal position and improve the cosmesis .