尿道下裂伴发前列腺囊的诊断及治疗  

The diagnosis and treatment of the prostatic utricle associated with hypospadias

作　　者：刘俊宏[1] 李旭良[1] 魏光辉[1] 林涛[1] 何大维[1] 刘丰[1] 华燚[1] 

机构地区：[1]重庆医科大学儿童医院泌尿外科,400014

出　　处：《中华小儿外科杂志》2005年第10期514-516,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨尿道下裂伴发前列腺囊的诊断及治疗方法。方法对近4年收治的重型尿道下裂进行尿道造影检查,然后根据尿道下裂程度、囊肿大小、位置,分别采用经会阴、经腹会阴囊肿切除,同时行尿道成形治疗。结果重型尿道下裂146例确诊伴发前列腺囊18例(12.3%),其中尿道造影证实13例,手术探查证实5例。经会阴囊肿切除14例中行Dupply+DuckettⅠ期尿道成形6例,Ⅰ期治愈4例,另8例先行Dupply尿道成形术,半年后再次尿道成形治愈;经腹会阴囊肿切除+Dupply尿道成形1例;保留囊肿仅行阴囊中隔皮瓣翻转尿道成形3例均Ⅰ期治愈。结论尿道造影对术前明确重型尿道下裂是否伴发前列腺囊很有必要,伴发前列腺囊者大多可经会阴切除,囊肿切除并不影响尿道下裂治疗效果。Objective To review the diagnosis and treatment of the prostatic utricle associated with hypospadias. Methods The voiding cystourethragraphy （VCU） was performed in all severe hypospadias patients to detect utricle. According to the type of the hypospadias, the size and site of the utricle, the utricle was resected by perineal approach or combined abdominal and perineal approach. Results Of the 146 severe hypospadias patients, 18 cases of utricles were diagnosed. 13 cases were diagnosed by VCU, and 5 cases by exploratory operation. Of the 14 cases whose utricles were resected, 6 cases were treated combined with Dupply and Duckett urethroplasty and 4 cases were managed with one stage procedure, and other 8 cases were managed with combined with Dupply operation. 1 case was managed with Dupply urethroplasty and utricle resection by combined abdominal and perineal approach. 3 cases whose utricles were reserved were treated only by urethroplasty. Conclusions VCU is helpful to diagnose utricle in severe hypospadias. Utricle could be resected in most cases by perineal approach.

关 键 词：前列腺囊 尿道下裂 尿道 诊断及治疗 伴发 尿道成形术 囊肿切除 阴囊中隔皮瓣 经腹会阴 尿道造影 

分 类 号：R726.92[医药卫生—儿科]