Snodgrass和Duckett尿道成形术治疗中后位尿道下裂261例分析

Snodgrass and Duckett surgical styles in the treatment of middle and posterior hypospadias:an analysis of 261 cases

目的：总结Snodgrass和Duckett两种尿道成形术治疗中间位、后位尿道下裂的经验与体会。方法：对2008年1月~2012年12月接受Snodgrass和Duckett尿道成形术治疗的261例中间位及后位尿道下裂患者情况进行回顾性分析。结果：Snodgrass术与Duckett术尿道瘘的发生率分别为11.9%（15/126）和8.1%（11/135）,尿道狭窄发生率分别为4.8%（6/126）和5.9%（8/135）,差异无统计学意义（均P〉0.05）;中间位与后位尿道下裂尿道瘘的发生率分别为7.0%（10/142）和13.4%（16/119）,尿道狭窄的发生率分别为3.5%（5/142）和7.6%（9/119）,差异有统计学意义（均P〉0.05）;后位尿道下裂并发症的发生率高于中间位尿道下裂。结论：对阴茎头发育较好,尿道板发育良好,中、轻度阴茎下弯者,采用Snodgrass术是理想的手术选择。对背侧包皮发育良好,阴茎下弯明显需横断尿道板者,采用Duckett术是一种较好的手术选择。

Objective：To summarize the experience of Snodgrass and Duckett surgical styles in the treatment of middle and posterior hypospadias.Method：From January 2008 to December 2012 we retrospectively analyzed261 cases of middle and posterior hypospadias who accepted Snodgrass or Duckett surgical style.Result：The incidence of urethral fistula were 11.9%（15/126）and 8.1%（11/135）,and the incidence of urethral stricture were4.8%（6/126）and 5.9%（8/135）for Snodgrass and Duckett surgical styles respectively.No statistical significant difference was found（all P〉0.05）.The incidence of urethral fistula rates were 7.0%（10/142）and 13.4%（16/119）,and urethral stricture rates were 3.5%（5/142）and 7.6%（9/119）in patients with middle or posterior hypospadias respectively.Also,no statistical significant difference was found（all P〉0.05）.Patients with posterior hypospadias experienced significantly higher incidence of complication than those with middle hypospadias（P〈0.05）.Conclusion：For patients with well-developed glans,well-developed urethral plate,medium and mild penile bending,Snodgrass technique is an ideal surgical choice.For patients with well-developed dorsal foreskin and obvious penile bending,Duckett urethral plate transection surgery is a good surgical option.