阴茎根部交错皮瓣在重度尿道下裂合并阴茎阴囊转位手术中的应用  

The application of penile base staggered flap in the operation of severe hypospadias with penoscrotal transposition

作　　者：朱小江[1] 黄立渠 董隽 马耿[1] 葛征 郭云飞[1] Zhu Xiaojiang;Huang Liqu;Dong Jun;Ma Geng;Ge Zheng;Guo Yunfei(Department of Urology,Children＇s Hospital of Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学附属儿童医院泌尿外科,210008

出　　处：《中华整形外科杂志》2018年第8期614-617,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探讨阴茎根部交错皮瓣在治疗重度尿道下裂合并阴茎阴囊转位中的应用。方法在尿道成形后，将阴茎根部与阴囊交界处皮肤横向剪开1．5～2．0cm，使阴囊向下移位，然后将剪开的阴茎阴囊处皮瓣以Z形交错缝合成形阴茎阴囊角，从而一期矫治尿道下裂合并阴茎阴囊转位。结果临床治疗23例，术后1例患儿交错皮瓣缝合处出现感染开裂，经换药对症处理后治愈；2例患儿交错皮瓣缝合处出现漏尿，其中1例自愈，另1例行尿瘘修补术；3例患儿出现冠状沟瘘，经再次尿道成形术治愈。随访10～30个月，所有患者尿道下裂及阴茎阴囊转位均得到矫治，尿道开口位置正常，阴茎体无下曲，阴茎阴囊位置正常，外观满意。结论该方法可以在尿道成形术同期矫治阴茎阴囊转位，操作相对简单，效果满意。Objective To explore the application of penile base staggered flap in the operation of severe hypospadias with penoserotal transposition. Methods Twenty-three cases with severe hypospadias with penoscrotal transposition were corrected by urethroplasty and staggered flap plasty in our department from May 2013 to June 2016. After urethroplasty, the skin at the junction of the penile base and scrotum was transversely cut by 1.5 - 2.0 cm, and then sutured with Z-plasty to reconstruct the angle of the penis and scrotum. Results After the operation, infection and cracking at the suture of the staggered flap occurred in one child and was cured after dressing change and symptomatic treatment. Two cases suffered from urine leakage at the suture of the staggered flap. One of the cases realized self-healing and the other received a repair operation for urinary fistula. Three children suffered coronary sulcus fistula and was cured by urethroplasty. All the patients were followed up from 10 to 30 months with normal penis scrotal position and satisfactory appearance. Conclusions The application of penile base staggered flap can be used for severe hypospadias in one stage with penoscrotal transposition surgery. It is a simple and satisfactory method for the treatment of hypospadias with penoserotal transposition.

关 键 词：尿道下裂 阴茎阴囊转位 尿道成形术 外科皮瓣 

分 类 号：R726.9[医药卫生—儿科]