尿道下裂术后复杂并发症阴茎部尿道的重建手术

目的]探讨采用隧道埋藏尿道法重建阴茎部尿道治疗尿道下裂术后复杂并发症的疗效.方法]对46例尿道下裂术后复杂并发症行阴茎部尿道重建手术病例分两组:新术式组采用阴囊中缝皮瓣成形尿道,阴茎部皮下隧道埋藏尿道法治疗29例.传统术式组按文献方法重建及修复尿道下裂术后阴茎部尿道17例.结果]随访3个月至4年,传统术式组,一次手术成功率58.9%,并发症较多.新术式组,一次手术成功率93.1%,并发症较少.两组并发症发生率及一次手术成功率相比有显著性差异(P＜0.01).结论]阴囊中缝皮瓣成形尿道,阴茎部皮下隧道埋藏尿道法是尿道下裂术后阴茎部尿道重建的有效术式,优于传统术式.

The Penile Urethral Reconstruction for Postoperative Complex Complications of Hypospadias

Objective]To review the penile urethral reconstruction for postoperative complex complications of hypospadias. Methods]Forty six cases of the penile urethral reconstructions from 1989 to 2005 were ana- lysed. They were divided into two groups,in the new technic group, the middle skin flap of scrotum was adopted to form penile urethra and past via modified subcutaneous tunneling in 29 cases. The conventional methods widely adopted by others were used in 17 cases. Results]The patients were foil, owed up for 3 months to 4 years. The success rate in the conventional group was 58. 9% with more complications, and in the new technic group, that was 93.1% with less complications. There were significative differences in the operation success rate and complications. Conclusion]The new method using the middle skin flap of scrotum to form penile urethra past via modified subcutaneous flap is an effective treatment. It is supperior to the conventional methods.