YV皮瓣法尿道口成形术在尿道下裂术后远端狭窄中的应用

Application of YV technology in distal stricture after hypospadias surgery

目的:探讨YV皮瓣法尿道口成形术在尿道下裂术后远端狭窄中的应用及疗效。方法:回顾性分析2015年12月~2019年11月我中心采用YV皮瓣法尿道口成形术治疗尿道下裂术后远端狭窄的37例患者的临床资料,年龄1岁2个月~16岁,平均5岁10个月,尿道狭窄长度0.3~1.5 cm。术后监测尿流率、膀胱残余尿量等,记录排尿情况、有无狭窄复发等。结果:无失访病例,随访时间6~54个月,平均28个月。35例经YV法治疗后狭窄缓解,2例复发。5例梗阻解除后存在膀胱排空障碍,其中2例后期恢复。3例术后早期出现尿线喷洒、偏斜,后期改善。结论:尿道狭窄应合理干预。YV皮瓣法尿道口成形术操作简单,尿道口径和外形更有保障,可为治疗尿道下裂术后远端狭窄提供新思路。

Objective:To investigate the application and efficacy of YV technique in distal stricture after hypospadias surgery.Method:A retrospective analysis was conducted on the clinical data of 37 patients who underwent YV technique for distal stricture after hypospadias surgery in our center from December 2015 to November 2019.The age ranged from one year and two months to sixteen years with an average of five years and ten months.The length of urethral stricture was 0.3 to 1.5 cm.After surgery,uroflowmetry and bladder residue urine were monitored.Urination status and stricture recurrence were also recorded.Result:All patients were followed up for 6 to 54 months with an average of 28 months.After YV technique,stricture recurred in 2 cases.Five cases had bladder emptying disorder after obstruction being resolved,2 of which recovered later.In 3 cases,urinary line spraying or deflection appeared in the early stage after surgery,which were improved in the later stage.Conclusion:Urethral stricture should be reasonably intervened.YV technique is simple and effective,so it can provide a new way to treat postoperative distal stricture of hypospadias.