利用横断后尿道板组织修复近段型尿道下裂的术式研究进展

Research advances in related operative approaches of repairing proximal hypospadias with severed urethral plate tissue

尿道下裂(hypospadias)是儿童泌尿生殖系统常见的先天畸形之一,发病率较高且有增加趋势,其中近段型尿道下裂占比逐年增加,严重影响患儿阴茎发育。近段型尿道下裂多合并严重阴茎下弯,手术治疗以横断尿道板术式为主,术后并发症发生率明显高于保留尿道板术式。目前,Duckett术式的应用最为广泛,但存在手术操作困难以及尿道狭窄、尿道憩室等并发症发生率较高等问题,影响治疗效果。近年来利用横断后尿道板组织的手术方式不断增多。本文对该类术式进行综述,以期为临床医生选择近段型尿道下裂术式提供参考。

Hypospadias is one of the most common congenital malformations in pediatric urogenital system with a high incidence rate.The rising proportion of proximal hypospadias has seriously affected pediatric patients'penile development.Most proximal hypospadias cases are complicated with severe penile curvature and treated with transverse urethral plate resection.But such surgical procedure has a significantly higher incidence of postoperative complications than retaining urethral plate.Currently Duckett's procedure is widely applied for proximal hypospadias.However,it is difficult to operate and faces common complications of urethral stricture and diverticulum.In recent years,more and more surgical approaches have been developed for preserving transverse urethral plate.This review discusses various operative approaches to provide clinicians with practical references for proximal hypospadias repair.