尿道下裂一期修复术:应用双侧阴茎浅动脉腹外侧支皮瓣再造尿道

One Stage Repair for Hypospadia: Urethra Reconstruction Using Bilateral Ventral Lateral Branch of the Superficial Penis Artery Flap

目的探索一种能有效防止术后尿道狭窄、尿瘘的一期尿道下裂修复技术。方法彻底矫直阴茎下弯畸形之后,即时在裂隙两侧缘形成2条适当宽度的阴茎浅动脉腹外侧支岛状筋膜皮瓣再造尿道。经隧道或剖开龟头,将尿道置于适当位置并开口于龟头远端。用阴囊中隔皮瓣旋转180°,覆盖阴茎腹侧创面,一次手术完成尿道下裂修复。结果修复阴茎阴囊型尿道下裂13例,再造的尿道及转移的阴囊皮瓣均100%成活,手术一次成功。随诊6个月～8年,13例均无尿道狭窄或尿瘘发生,阴茎完全挺直,排尿在龟头远端,尿路通畅成线。尿道吻合口处发生憩室1例。结论实施该技术的一期尿道下裂修复术,具有防瘘及成功率高之优点,可供临床医师选用。

Objective Finding a hypospadia repair technique which could adequately prevent postoperation urethra stenosis and leakage.Methods Completely correct any penis curvature deformity;at both side of the cleft a proper sized island fascia flap supplied by the ventral lateral branch of the superficial penis artery was raised simultaneously to form the urethra.The new urethra was fixed at the right position and meatus at the distal end of the glans through a channel or making an incision at the distal glans.Scrotal septa flap was rotated 180 degree to cover the ventral wound.The urethra was reconstructed in one stage.Results 13 patients with penis-scrotal type hypospadia were treated with this technique.All the reconstructed urethra and transferred flaps were survived.Successful repair was achieved in one operation.With 6 months to 8 years follow up,there was no complications such as suture line leakage and stenosis noticed.The penis remained straight and the meatus at the distal glans with good patency.Only one patient developed a cyst at the proximal suture line of the reconstructed urethra.Conclusion This technique has minimal leakage rate and high successful rate.So it is a good choice for clinicians in the repair of hypospadia.