尿道板增宽阴茎头结合层面外科技术在尿道下裂合并小阴茎头治疗中的应用

Application of urethral plate widening glans penis combined with lamellar surgical techniques in the treatment of hypospadias with small glans penis

目的探讨横形带蒂包皮瓣尿道成形术(Duckett)基础上利用尿道板加强阴茎头组织来增宽阴茎头两侧翼,结合层面外科技术在治疗先天性尿道下裂合并小阴茎头畸形的疗效。方法以中国人民解放军联勤保障部队第九二四医院泌尿外科院2017年6月—2020年10月收治的22例先天性尿道下裂合并小阴茎头畸形患者为研究对象,在Duckett术基础上利用尿道板替代阴茎头组织增宽阴茎头两侧翼,结合层面外科技术充分游离阴茎头两侧翼及尿道板行尿道成形术,观察手术成功率及随访并发症发生率。结果22例患者中19例手术成功,成功率86.3%,阴茎头段尿道成形术成功率达到96.1%。结论在Duckett术基础上,应用尿道板增宽阴茎头结合层面外科技术治疗尿道下裂合并小阴茎头患者,可提高阴茎头段尿道成形手术的成功率。

Objective To investigate the effects of lamellar surgical techniques with urethral plate to strengthen the tissue of glans penis to widen the two flanks of glans penis on the basis of Duckett method in the treatment of congenital hypospadias with small glans penis deformity.Methods A total of 22 patients admitted to our hospital during Jun.2017 and Oct.2020 were involved.Urethral plate was used to replace the glans penis tissue to widen the two flanks of glans penis based on Duckett method.Lamellar surgical techniques were adopted to fully dissociate the two flanks of glans penis and urethral plate for urethroplasty.Results Of the 22 operations,19 were successful,with a success rate of 86.3%.The success rate of penile head urethroplasty reached 96.1%.Conclusion Widening the glans penis by using the urethral plate based on Duckett method combined with lamellar surgical techniques can improve the success rate of glans penis urethroplasty.