阴部外动脉阴茎皮瓣尿道成形术的应用解剖

Applied anatomy in urethroplasty by penile flap with external pudendal artery

目的 为设计阴部外动脉阴茎皮瓣转位尿道成形术提供依据。方法 30侧经动脉内灌注红色乳胶的成人尸体 ,解剖观测阴部外动脉起始、行程及其阴茎支在阴茎的走行、分支分布。结果 阴部外动脉始于股动脉 ,外径(1.8± 0 .4 )mm ,伴行静脉 1～ 2支 ,汇入大隐静脉。阴部外动脉阴茎支可视为阴茎支即阴部外动脉主干的延续 ,经耻骨结节两侧靠近阴茎 ,分别经 2 (10 )点、3(9)点和 1(11)点进入阴茎 ,多数分出背侧支和腹侧支分布于阴茎皮肤 ,外径(0 .8± 0 .2 )mm。结论 阴茎皮肤血管恒定 ,以阴部外动脉为蒂 ,可在阴茎外侧或背外侧、腹外侧设计皮瓣 ,用于尿道成形术。术式在临床应用效果满意。

Objective To provide the anatomic basis for design a flap of penis with external pudendal artery pedicle and transposed for urethroplasty. Methods The origin and course of the external pudendal artery in penis were observed on 30 adu1t specimen by red latex infusion technique. Results The external pudenda1 artery is originated form femoral artery with an external diameter of (l.8±0.4)mm and 1～2 branches of concomitant veins are drained into great saphenous vein. The penile branch is the elongation of exterma1 pudendal artery, which distributes near the penis along two sides of pubic tubercle and penetrating into penis at 2(10) oclock, 3(9)oclock and l(11)oclock. Many of the arteries send dorsal and ventral branches to distribute the skin of penis. Conclusion The vessels of skin of penis are regular, so the flap may be designed at dorso-lateral or ventro-latral side of penis with penile branch for urethroplasty. Clinical applications of the flap for hypospadia were successful.