弧形带蒂阴茎皮肤联合皮瓣Ⅰ期治疗重度尿道下裂

目的：报道弧形带蒂包皮内板阴茎背侧皮肤联合皮瓣治疗阴囊型及会阴型尿道下裂。方法：22例阴囊型及会阴型尿道下裂患者，均采用弧形带蒂包皮内板阴茎背侧皮肤联合皮瓣(Ducrett Perovic’s)制成皮管I期成形尿道。术中常规耻骨上膀胱穿刺造瘘引流尿液，经尿道置F10-12多侧孔硅胶管支架引流尿道分泌物，术后应用头孢曲松钠抗感染治疗1周，保留尿道支架管6～8d，膀胱造瘘管10～12d。结果：18例I期成功，4例发生尿瘘，均于6个月后修补瘘管痊愈。均排尿正常，无痛性勃起，阴茎无扭转，腹侧无臃肿。结论：此法治疗包皮阴茎皮肤充裕之重度尿道下裂效果确切，外观满意，是一种较好的手术方式．

A modified flap technique for treatment of severe hypospadias

Purpose:To present a modified flap technique for treatment of severe hypospadias. Methods:Twenty two cases of severe hypospadias were treated by the modified flap technique using Duckett's method plus Perovic's method in one stage.Suprapubic diversion was used for uring drainage,and 10F or 12F tube was inserted to the proximal end of new urethra. After the operation ceftriaxone was used in all patients for one week.Urethral tubes were removed at 6 or 8 days after operation and the suprapubic tubes at 10 or 12 days. Results:One stage healing was successfully achieved in 18 patients.Four patients suffered from fistula which were successfully repaired through reoperation at six months later.After the operation,all patients have had normal urination and good appearance. Conclusions:This surgical method was a good treatment for severe hypospadias with satisfactory results and good appearance.