尿道下裂尿道成形术后尿瘘的修复

总结尿道下裂尿道成形术后尿瘘１１７例。一次修补成功率６２．４％，其中大瘘为５２．４％，小瘘７０％。大尿瘘修补用Ｄｕｐｌａｙ、Ｔｈｉｅｒｓｃｈ、Ｄｕｃｋｅｔｔ、Ｄｅｎｉｓ－Ｂｒｏｗｎｅ、Ｍａｔｈｉｅｕ等尿道成形术。小瘘用结扎法、简单切开缝合法、Ｙ－Ｖ皮瓣覆盖尿瘘修补法。对各种方法的应用指征、手术效果、术前术后的处理及影响手术的因素作了探讨。

Menagement of Urethral Fistulas Fistulas Resulted From Hypospadias Repair

A retrospective analysis of urethral fistula in recent 6 years was made in order to choose a proper procedure for repair. There were 117 cases who received 155 urethral fistula repairs which were performed at least 6 months after the previous operation. The method of repair was chosen mainly on the size of the urethral fistula , so it was divided into two groupos: small fistula and larger one. Seventy-three cases were cured by one operation (successful rate: 62. 4%). Large fistula required urethroplasty including: Duplay's (23), Thiersch's(19).Duckett's(3) .Denis-Browne's(11). Mathieu's ( 3),A them, Duplay's and Thiersch's were the common methods. The result of Thiersch's was better than Duplay's result(P<0. 05 ).Small fistulas were repaired by:1.ligation of the fistula (18).2. suturing of fistula and skin (55), 3. Suturing of the fistula and closing of skin by Y-V flap(23) which would cover the suture line of fistula with better results.Suture material and skillfulness of the operator were also the important factors.