阴茎纵行皮瓣尿道成形术治疗前尿道狭窄14例报告  

Preputial pedicle flap urethroplasty in the treatment of anterior urethral stricture:report of 14 cases

作　　者：胡忠良[1] 王梅[1] 胡贵金[2] 宋东峰[2] 金毅[2] 黄江[1] 吴敬杰[1,3] HU Zhong-liang WANG Mei HU Gui-Jin SONG Dong-feng JIN Yi HUANG Jiang WU Jing- jle(Department of Forensic Medicine, Guizhou Medical University, Guiyang 550000 Department of Urol-ogy, No. 211 Hospital of People＇s Liberation Army, Harbin 150086 Guizhou Police College, Guiyang550005, China)

机构地区：[1]贵州医科大学法医学院,贵州贵阳550000 [2]中国人民解放军第211医院泌尿外科,黑龙江哈尔滨150086 [3]贵州警官职业学院,贵州贵阳550005

出　　处：《现代泌尿外科杂志》2017年第6期421-423,共3页Journal of Modern Urology

基　　金：贵州省优秀科技教育人才省长专项资金项目(No.200758)

摘　　要：目的观察带蒂阴茎皮瓣尿道成形术治疗前尿道狭窄的临床效果。方法采用带蒂阴茎皮瓣尿道成形术治疗14例前尿道狭窄患者,年龄(38.14±12.63)岁;尿道狭窄病史(26.71±62.06)个月;尿道扩张治疗史12例(85.71%),尿道内切开史9例(64.29%),膀胱造瘘术10例(71.43%);狭窄病因为创伤性10例(71.43%)、医源性3例(21.42%)、炎症性1例(7.14%);尿道狭窄长2~10cm,平均长度(3.35±2.07)cm。结果 14例患者手术顺利。术后随访3~30个月,平均(15.71±8.25)个月,12例术后排尿顺畅,最大尿流率(21.92±6.47)mL/s;1例术后尿道轻度狭窄经尿道扩张后排尿满意,余1例长段尿道狭窄术后合并尿道旁感染致严重尿道狭窄,术后3个月行尿道切开术,待二期成形术。结论阴茎皮肤薄、血运丰富、取材操作简单,是修补≤10cm的前尿道狭窄较理想的材料之一。Objective To explore the clinical efficacy of preputial pedicle flap urethroplasty in the treatment of anterior urethral stricture.Methods A total of 14 patients with anterior urethral stricture were treated with preputial pedicle flap urethroplasty.The patients aged（38.14±12.63）years（range 24~62）,with a history of urethral stricture of（26.71±62.06）months（range 3~24）.Transurethral dilation was applied in 12 cases（85.71%）,transurethral incision in 9 cases（64.29%）,and bladder stoma in 10 cases（71.43%）.The stricture was caused by trauma in 10 cases（71.43%）,by iatrogenic lesion in 3 cases（21.42%）,and by inflammation in 1 case（7.14%）.The length of urethral stricture was 2~10 cm,average（3.35±2.07）cm.Results All operations were successful.After a follow-up of 3 to 30 months（mean 15.71±8.25）,12 patients voided smoothly,with Qmax of 16~35 mL/s（mean21.92±6.47）.Mild urethral stricture occurred in 1 case,which was cured by urethral dilatation.One case suffered severe urethral stricture due to postoperative urethral infection,received transurethral urethrotomy after 3 months,and waited for the second-stage operation.Conclusion Preputial skin flap is convenient and simple for the treatment of anterior urethral stricture less than10 cm,which has the advantages of few complications and high success rate.

关 键 词：前尿道狭窄 阴茎皮瓣 尿道成形术 

分 类 号：R691.4[医药卫生—泌尿科学]