尿道板镶嵌及尿道海绵体成形在TIP尿道下裂修复中的应用

The application of urethral plate inlay and urethral cavernous body forming in the repair of TIP hypospadias

目的评估尿道板镶嵌及尿道海绵体成形在尿道板切开卷管(tubularized incised plate,TIP)尿道下裂修复中的应用效果。方法对自2015年1月至2016年10月收治的16例初次手术的远端型尿道下裂患儿均行TIP术式修复。术中在尿道板纵切创面镶嵌移植包皮内板或颊黏膜,并将尿道板两侧分叉的尿道海绵体合拢成形,覆盖于再造尿道腹侧。结果本组16例患儿均一期手术修复成功,术后随访6~24个月,平均10个月。无尿瘘及尿道狭窄发生,除1例尿道口退缩外,其余患儿尿道开口正位、裂隙状,阴茎无弯曲,术后外观好。结论尿道板镶嵌及尿道海绵体成形可以减少尿道狭窄及尿瘘发生,对TIP术式起到了良好的辅助作用。

Objective To evaluate the efficacy of urethral plate inlay and urethral cavernous body forming in the repair of TIP hypospadias. Methods From January 2015 to October 2016, 16 children with primary distal hypospadias underwent urethral plate inlay and spongioplasty assisted TIP urethroplasty for hypospadias repair. The mean age was 4.3（2 to 13） years.Plate width was 4 to 8 mm. The foreskin or buccal mucosa was inlaid in the urethral plate with a longitudinal incision during the operation. The forked cavernous body of the urethra was gathered on both sides of the urethral plate, covering the ventral urethra reconstruction. Results All patients were cured in one stage surgery, followed up for 6 to 24 months, for an average of 10 months. No urinary fistula and urethral stricture occurred. Except for one case of urethral retraction, all other patients had crack-like urethral openings in the front, no penile curvature, and good postoperative appearance. Conclusion Urethral plate inlay and urethral cavernous body forming can reduce the urethral stricture and urinary fistula,and is effective for hypospadias repair.