分期手术在尿道下裂修复中的应用

Efficacy of two-stage urethroplasty for hypospadias repair

目的评价尿道下裂分期手术的疗效,并与一期手术比较,分析其优缺点。方法自2006年6月至2015年6月我们对320例尿道下裂患者行尿道下裂分期手术,均一期先行阴茎下曲矫正,包皮内板腹侧转移术;待6个月后行二期带蒂包皮卷管尿道成形术。结果 320例中,二期手术成功290例(290/320,90.6%),出现尿瘘28例(28/320,8.75%),尿道狭窄2例(2/320,0.65%)。结论①分期手术成功率与一期手术成功率相近,但尿道狭窄发生率明显减少。②分期手术外观更接近正常生理状况。③分期手术适应症广泛,特别适用于长段尿道缺损、阴茎龟头裂开,多次手术失败、阴茎细小病例。④分期手术可简化操作,手术成功率保障性高,值得推广应用。

Objetive To explore the efficiency of two -stage urethroplasty for hypospadias re-pair. Methods From June 2006 to June 201 6,320 cases of hyospadias were corrected with two-stage meth-od.During the first stage,chordee was corrected and dorsal prepuce rotated to ventrum.Six months later,ure-throplasty （second-stage operation）was performed with perimeatal skin flap. Results A total of 209 cases were thoroughly corrected （90.6%）.Complications included fistula （n =28,8.75%）and stenosis （n =2, 0.65%）. Conclusions As compared with one-staged repair,the success rate of two-stage method is compa-rable yet with less stenosis and streamlined process.The cosmetic outcomes are better.It is also effective for severe cases of glanular dishescense,micropenis,long -defect urethra and multiple failures.