尿道下裂阴茎分叉尿道海绵体解剖特点及应用  

Anatomical characteristics of the divergent corpus spongiosum in hypospadias and its application

作　　者：谢林海[1] 李森恺[1] 李强[1] 周传德[1] 李峰永[1] 周宇[1] 胡金天[1] 丁健[1] 曹玉娇[1] 

机构地区：[1]北京协和医学院中国医学科学院整形外科医院整形十科,北京100144

出　　处：《中国美容整形外科杂志》2013年第1期32-35,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：【摘要】目的评价尿道下裂阴茎分叉尿道海绵体畸形特点对尿道成形的作用。方法对9例初治尿道下裂患者，根据其解剖特点设计并整体剥离分又尿道海绵体及表面皮肤、尿道板，形成一复合组织瓣，耦合口腔黏膜或皮片成形尿道，并将分又尿道海绵体合并成形以覆盖尿道。结果本组共9例患者，全部I期治愈，除1例短期的阴茎远端水肿外，无其他并发症发生。随访3～7个月，该瓣血供好，宽度足；分叉海绵体成形后可部分覆盖新尿道，阴茎形态满意。结论保留分又尿道海绵体合并成形用于尿道覆盖，可能有助于减少尿瘘、尿道狭窄及憩室等并发症，重建近似正常的尿道，且不影响阴茎矫直。Abstract： Objective To evaluate the effect of anatomical characteristics of the divergent corpus spongi- osum in urethroplasty. Methods According to its anatomical characteristics, the divergent corpus spongiosum, skin beyond it, and the urethral plate were partly detached from the albuginea as a whole to form a compound flap, urethroplasty was performed using the flap coupling with oral mucosa or skin graft in 9 cases. The diver- gent corpus spongiosum was used as coverage for the new urethra after spongioplasty. Results The flap was well vascularized and wide enough for urethroplasty. Spongioplasty provided a reliable coverage for new urethra except for short-term distal penile edema in one case, and all patients were cured without any complications, penile appearance was well. Conclusion The divergent corpus spongiosum may be used as coverage for new u- rethra to avoid fistula, stricture, and diverticulum, etc, without causing residual or recurrent curvature, recre- ates a nearly normal urethra in some cases.

关 键 词：尿道下裂 尿道海绵体 尿道成形术 尿瘘 尿道狭窄 畸形 

分 类 号：R695[医药卫生—泌尿科学] R699.6[医药卫生—外科学]