纵行带蒂包皮瓣卷管尿道间置矫治先天性DonnahooⅣ型阴茎下曲畸形  

LONGITUDINAL PREPUTIAL PEDICLED FLAP URETHROPLASTY FOR CHORDEE OF Donnahoo TYPE Ⅳ

作　　者：曾莉[1] 单伟[1] 袁淼[1] 黄桂珍[1] 黄鲁刚[1] 

机构地区：[1]四川大学华西医院小儿外科,成都610041

出　　处：《中国修复重建外科杂志》2012年第11期1352-1355,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨纵行带蒂包皮瓣卷管尿道间置矫治先天性DonnahooⅣ型阴茎下曲畸形的疗效。方法 1994年6月-2011年10月,采用纵行带蒂包皮瓣卷管尿道间置矫治先天性DonnahooⅣ型阴茎下曲畸形患者30例。年龄2～16岁,平均5.8岁。入院检查:阴茎头-舟状窝-尿道外口形态以及与邻近组织关系正常;阴茎长度2.5～6.8 cm,平均4.3 cm;弯曲角度35～70°,平均40.1°。初次手术27例,再次手术3例。皮瓣切取范围1.5 cm×1.3 cm～4.0 cm×2.0 cm。结果下曲畸形矫正后阴茎长度3.0～8.5 cm,平均6.6 cm;弯曲角度0～10°,平均1.2°。术后患者均获随访,随访时间6个月～12年,平均33个月。随访期间无阴茎下曲复发,阴茎头无刺痛、异物感等不适。4例(13.33%)拔除尿管后出现尿瘘,行尿瘘修补术后无复发;2例(6.67%)术后1个月出现尿线变细、排尿困难,给予尿道扩张后症状消失。其余患者均无明显并发症发生,尿流无散射,方向性好。6例随访至成年,诉性功能满意,无明显勃起障碍、勃起疼痛及性交困难等。结论纵行带蒂包皮瓣卷管尿道间置矫治先天性DonnahooⅣ型阴茎下曲畸形具有操作简便、疗效确切等优点。Objective To investigate the effectiveness of longitudinal preputial pedicled flap urethroplasty for chordee of Donnahoo IV type.Methods Between June 1994 and October 2011,30 patients with chordee（Donnahoo type IV） underwent longitudinal preputial pedicled flap urethroplasty.The patients＇ age ranged from 2 to 16 years（mean,5.8years）.The morphology of the balanus-navicular fossa-external urethral orifice ranged normal;the penis length was 2.5-6.8 cm（mean,4.3cm）;the penis bending angle was 35-70°（mean,40.1°）.Primary and secondary operation was 27 cases and 3 cases,respectively.The size of flap ranged from 1.5 cm × 1.3 cm to 4.0 cm × 2.0 cm.Results After correction,the penis length was 3.0-8.5 cm（mean,6.6 cm）;the penis bending angle was 0-10°（mean,1.2°）.All patients were followed up 6 months to 12 years（mean,33 months）.No recurrence,stabbing pain of the balanus,or foreign body sensation occurred during follow-up.Of them,4 patients（13.33%） had urinary fistular,they had satisfactory results after the second operation;2 patients（6.67%） had urethral stricture 1 month after operation,they also had satisfactory results after arethral dilatation.The other patients showed no scattering urinary flow and good direction without complication.Six patients had satisfactory sexual function after puberty without erection disorder,pain,or dyspareunia.Conclusion Longitudinal preputial pedicled flap urethroplasty can achieve maximum utilization of prepuce and aesthetic and functional improvement with less complication,so it is a relatively ideal mean for treating chordee of Donnahoo type Ⅳ.

关 键 词：阴茎下曲畸形 纵行带蒂包皮瓣 尿道间置 

分 类 号：R726.9[医药卫生—儿科]