尿道板卷管阴囊中隔皮瓣覆盖阴茎创面尿道成形术治疗复杂性尿道下裂

Urethral reconstruction using tublarized incised plate and scrotal-septal fasciocutaneous flap as coverage for treatment of complex hypospadias

目的探讨尿道板卷管阴囊中隔皮瓣覆盖阴茎创面尿道成形术治疗复杂性尿道下裂的手术疗效。方法回顾性分析自2012年10月至2016年6月收治的41例复杂性尿道下裂患者,年龄4~29岁,均有1次以上的手术史,阴茎均已经伸直。21例患者采用尿道板卷管阴囊中隔皮瓣覆盖阴茎创面的尿道成形术和同期20例采用舌粘膜嵌入尿道板卷管尿道成形术式相比较。术后定期随访及尿流率检查。结果术后随访平均15个月。尿道板卷管阴囊中隔皮瓣覆盖阴茎创面的尿道成形术21例患者手术时间明显短于舌黏膜嵌入尿道板卷管尿道成形术式手术时间,P<0.01。手术的成功率无明显差异,P>0.05。结论对于阴茎已经伸直的复杂性尿道下裂患者,采用尿道板卷管阴囊中隔皮瓣覆盖阴茎创面尿道成形术是较好的选择。

Objective To retrospectively summarize the clinical application and efficacy of the urethral reconstruction u- sing tublarized incised plate and serotal - septal fasciocutaneous flap as coverage for the treatment of complex hypospadi- as. Methods From October 2012 to June 2016,41 complex hypospadias （ ranging form 4 to 29Y, mean age 8 years） were enrolled. All patients have undergone repeated failed urethroplasties and no penile curvature or chordee existed. 21 patients underwent one - stage urethroplasty by using tublarized incised plate and scrotal - septal fasciocutaneous flap as coverage. 20 patients underwent hypospadias repair by using lingual mucosal graft and the dorsal inlay method was used. All of the patients were followed up and the uroflowmetry was performed. Results The mean follow - up time was 15 months. There were no significant between two groups in the success rate of the surgery and complication （P 〉 0. 05 ）. But there was a significant difference on the operation time between two groups, and the scrotal -spetal flap group were superior to those in the lingual mucosal graft group （P 〈 0. 01 ）. Conclusion Using tublarized incised plate and scrotal - septal fasciocutaneous flap as coverage,is a good choice for the treatment of complex hypospadias.