保留尿道板手术在尿道下裂治疗中的应用

Preservation of urethral plate in hypospadias repair

目的 探讨保留尿道板手术治疗尿道下裂的疗效。方法 总结分析 189例保留尿道板的尿道下裂修复手术。结果 保留尿道板手术总成功例数 177/189(93.6 5 % ) ,其中采用尿道口基底皮瓣法 (Mathieu法 ) 39/4 2例 (92 .86 % ) ,加盖岛状皮瓣法 (Onlayislandflap法 ) 138/14 7例 (93.88% )。结论 保留尿道板手术适用于无或伴有轻度阴茎下弯的尿道下裂治疗。可按尿道口位置选择手术方法 :冠状沟型及阴茎体前型尿道下裂宜采用Mathieu法 ,阴茎体型及阴茎根型尿道下裂宜采用Onlayislandflap法。

Objective To evaluate the efficacy of urethral plate preserving procedures in hypospadias repair. Methods Between 1998 and 2001, 189 cases of hypospadias repair were retrospectively analyzed. Of them, 42 patients underwent Mathieu repair and 147 received Onlay island flap procedure. All 84 patients with mild curvature were performed on dorsolateral plication with non absorbable sutures to achieve penile straightening. Results The overall successful rate was 93.65% . The complication rate of Mathieu procedure was 7.14% and Onlay procedure 6.12% . Conclusions The choice of surgical procedure in hypospadias repair should be individualized. Preservation of the urethral plate is suitable for hypospadias with or without mild chordee. Mathieu procedure is recommended for anterior hypospadias. Onlay procedure is adapted to meatus that situated in the posterior third or at the base of shaft.