尿道板纵切卷管尿道成形术+睾丸鞘膜覆盖技术修复远段型尿道下裂50例报告  

Tubularized Incised Plate Urethroplasty + Perididymis Covering Technique for Fixing Distal Hypospadias:a Report of 50 Cases

作　　者：潘永斌[1] 邱伟全 高卫华[1] 何时鸣[1] 

机构地区：[1]广东省佛山市南海区妇幼保健院小儿外科,广东佛山528200

出　　处：《临床医学工程》2014年第2期199-200,共2页Clinical Medicine & Engineering

摘　　要：目的 评价尿道板纵切卷管尿道成形术＋睾丸鞘膜覆盖技术修复远段型尿道下裂的疗效.方法 50例远段形尿道下裂病人行尿道板纵切卷管尿道成形术＋睾丸鞘膜覆盖技术,年龄18月至12岁,冠状沟型15例,阴茎体型29例,尿道下裂术后失败者6例,选择的全部病例无均无严重阴茎下弯、阴茎龟头发育良好.18例行包皮脱套后仍有下弯者行阴茎背侧白膜折叠后下弯矫直满意.手术时间平均1.5小时,常规留置尿管10～12天.结果 50例均顺利实施尿道板纵切卷管尿道成形术＋睾丸鞘膜覆盖技术式,术后随访1年,尿瘘5例（10％）,均无尿道狭窄及尿道憩室发生,总治愈率90％,且阴茎外观满意,无阴茎下弯,尿道口呈裂隙状使阴茎头和尿道口更美观.结论 尿道板纵切卷管尿道成形术＋睾丸鞘膜覆盖技术适用于大部分无严重阴茎下弯、阴茎龟头发育良好的远段型尿道下裂患儿,且外观满意,并发症少,缩短手术时间,是较理想的手术方式.Objective To assess the application of tabularizations of the urethral plate （TUP） and tunica vaginalis flap （TVF） in repairing distal shaft hypospadias. Methods 50 patients underwent TUP and TVF in repairing distal shaft hypospadias, aging from 18 months to 12 years old, including 15 cases with coronal hypospadias, 29 cases with penile hypospadias, and 6 cases with failure in hypospadias repair. None of the patients suffered from serious chordee of penis, and they had well-developed glans. 18 patients received plication operation of penile dorsal buck after a failure in foreskin-deglove correction. The average time for each operation was 1.5 hours, and regular detaining urethral catheters were kept for patients from 10 to 12 days. Results Satisfactory results were obtained in 50 cases of TUP and TVF during a follow-up of 1 year after operation. No cases of urethral stricture or urethral diverticulum were found except 5 cases of urinary fistula. All the cases resulted in a good contour of the penis, without any ehordee of penis. Also, slit-shaped urethral meatus resulted in satisfactory glans and meatus urinarius. All the recovery rate was 90%. Conclusions TUP and TVF can be applied to most patients with distal shaft hypospadias who have well-developed glans and do not suffer from serious chordee of penis. All the cases can result in a good contour of the penis with a low complication rate and shorter period of time in operation. Therefore, TUP and TVF is an operation with satisfactory results.

关 键 词：远段型尿道下裂 尿道板纵切卷管尿道成形术 睾丸鞘膜覆盖技术 

分 类 号：R726.9[医药卫生—儿科]