带蒂皮瓣尿道外口成形术治疗炎症性尿道外口狭窄  

Meatoplasty with pedicle flap for meatal stenosis secondary to chronic balanitis

作　　者：黄盛松[1] 桂亚平[1] 罗华荣[1] 吴旻[1] 张琪敏[1] 李军亮[1] 吴登龙[1] 

机构地区：[1]同济大学附属同济医院泌尿外科,上海200065

出　　处：《中华男科学杂志》2015年第7期630-633,共4页National Journal of Andrology

摘　　要：目的：探讨带蒂皮瓣尿道外口成形术治疗炎症性尿道外口狭窄的疗效。方法：2009年9月至2013年12月采用带蒂皮瓣法治疗尿道外口狭窄患者32例。所有患者既往均有慢性阴茎头炎病史,曾行尿道外口扩张或尿道外口切开,效果欠佳,最大尿流率（4.3±2.4）ml/s。术中于系带处＂∧＂形切开正常表皮,向阴茎近端游离表皮获得带蒂皮瓣,纵形切开尿道外口腹侧,充分切除无弹性瘢痕组织,将游离的＂∧＂形皮瓣嵌入尿道吻合,并重建尿道外口。结果：术后随访6~30个月,全部患者尿道外口狭窄完全解除,排尿通畅,最大尿流率（26.7±4.5）ml/s,无排尿刺激感,无勃起功能障碍。结论：本术式创伤小,并发症少,术后效果理想,是一种有效的、可行的手术方法。但术后阴茎头正常外观存在一定改变,远期疗效有待进一步观察。Objective： To evaluate the effect of meatoplasty with the pedicle flap in the treatment of meatal stenosis secondary to chronic balanitis. Methods： We retrospectively analyzed 32 cases of meatal stenosis secondary to chronic balanitis treated by meatoplasty with the pedicle flap. All the patients had a history of chronic balanitis and had received meatal dilatation or simple ventral meatotomy without significant effect. Their mean maximum urinary flow rate（ Qmax） was（ 4. 3 ± 2. 4） ml / s. During the operation,A ＂ ∧＂-shaped incision was made in the healthy epidermis and a flap was harvested from the frenulum. After complete removal of the scar,the flap was placed into the urethral wall,followed by reconstruction of the external urethral orifice. Results： The patients were followed up for 6 to 30 months,which revealed smooth urination in all the patients with Qmax of（ 26. 7 ± 4. 5） ml / s and normal erectile function and uresiesthesis. Conclusion： With little invasiveness and few complications,meatoplasty with the pedicle flap is an ideal surgical method for the treatment of meatal stenosis secondary to chronic balanitis. However,there might be some change in the normal appearance of the balanus postoperatively,and its long-term effect needs further observation.

关 键 词：尿道外口狭窄 尿道外口成形术 带蒂皮瓣 慢性阴茎头炎 

分 类 号：R699.6[医药卫生—泌尿科学]