改良阴茎头段Inlay术治疗尿道下裂患儿的短期疗效

Short-term efficacy of modified balanus Inlay graft urethroplasty for hypospadias in children

目的探讨改良阴茎头段Inlay术治疗尿道下裂患儿的方法及短期疗效。方法回顾性选取2020年3月至2023年3月在厦门大学附属妇女儿童医院行改良阴茎头段Inlay术治疗的121例尿道下裂患儿,年龄10~69个月,中位年龄19个月。所有手术均由同一术者完成。分析患儿的临床资料、术后并发症情况、最大尿流率(maximum urinary flow rate,Q_(max))及国际尿道下裂客观评分标准(Hypospadias Objective Scoring Evalution,HOSE)评分,评价其疗效。结果121例患儿中,首诊病例98例,其中阴茎体远端型26例,阴茎体中部型44例,阴茎体近端型21例,阴茎阴囊型7例;再手术23例,为前置手术1~4次。手术均一期完成并获得随访,随访时间为12~48个月。术后并发症:尿道瘘6例、尿道狭窄1例,无阴茎头裂开。术后2周的平均Q_(max)为(9.05±1.17)ml/s。所有患儿术后尿道口均位于阴茎头前端,呈垂直裂隙状,平均HOSE评分为(15.03±0.96)分。结论改良阴茎头段Inlay术修复小儿尿道下裂是安全、有效的,该术式操作简单,成功率高,术后外观良好,值得推广。

Objective To investigate the method and short-term efficacy of modified balanus Inlay graft urethroplasty for hypospadias in children.Method A total of 121 children with hypospadias who underwent modified balanus Inlay graft urethroplasty treatment by the same surgeon in Women and Children's Hospital Affiliated to Xiamen University from March 2020 to March 2023 were retrospectively selected,with a median age of 19 months,age ranged from 10 to 69 months.The clinical data,postoperative complications rate,maximum urinary flow rate(Q_(max)),and the Hypospadias Objective Scoring Evalution(HOSE)score were analyzed to evaluate the efficacy of the treatment.Result Of the 121 children,there were 98 prime treatment cases,including 26 cases of distal penile body type,44 cases of central penile body type,21 cases of proximal penile body type,and 7 cases of penile scrotal type.The 23 reoperation cases had underwent 1-4 anterior surgeries.All the surgery were completed in one phase,with a follow-up period of 12-48 months.Postoperative complications including 6 cases of urethral fistula,1 case of urethral stricture,and none of balanus rupture.The average Q_(max) at 2 weeks after surgery was(9.05±1.17)ml/s.All cases had postoperative urinary meatus located at the tip of glans with vertical fissure shape,with average HOSE score of(15.03±0.96)points.Conclusion The modified balanus Inlay graft urethroplasty for the repair of hypospadias in children is safe and effective.This procedure got simple operation,high success rate,and good postoperative appearance.It is worth promoting.