隐匿性阴茎合并尿道畸形诊治分析  

Treatments and efficacies of urethral deformity associated with concealed penis

作　　者：童方运 赵夭望 刘李 何天衢 王智[1] Tong Fangyun;Zhao Yaowang;Liu Li;He Tianqu;Wang Zhi(Department of Urology,The Affiliated Children's Hospital of Xiangya School of Medicine,Central South University(Hunan Children's Hospital),Changsha 410007,China)

机构地区：[1]中南大学湘雅医学院附属儿童医院(湖南省儿童医院)泌尿外科,长沙410007

出　　处：《临床小儿外科杂志》2024年第8期768-771,共4页Journal of Clinical Pediatric Surgery

基　　金：湖南省卫生健康委科研计划项目(B202304057979);湖南省儿童泌尿生殖疾病临床医学研究中心(2021SK4017)。

摘　　要：目的探讨隐匿性阴茎合并尿道畸形的手术治疗方式以及临床疗效。方法回顾性分析2019年1月至2023年3月湖南省儿童医院泌尿外科收治的17例隐匿性阴茎合并尿道畸形患儿临床资料。患儿均于隐匿性阴茎手术中翻转包皮后发现合并尿道上裂(6例)或尿道下裂(11例),遂行隐匿性阴茎矫正术加尿道上裂(或尿道下裂)修复术。收集患儿手术方式、治疗结果以及术后伤口感染、尿道瘘、尿道狭窄、阴茎背屈或阴茎下弯复发等并发症情况。结果17例均经手术治愈,其中1例阴茎体型尿道下裂患儿拔除导尿管后出现尿道瘘,1例尿道上裂患儿术后出现伤口感染、尿道裂开,均行尿道瘘修补及尿道成形术。17例于门诊随访6个月至3年,患儿阴茎外观良好,无一例阴茎背屈或阴茎下弯复发,无尿道狭窄及尿道瘘,自主排尿正常,术后6个月尿流率检查提示,合并尿道上裂者尿流率为(10.53±2.22)mL/s,合并尿道下裂者尿流率为(10.45±2.88)mL/s。结论对于合并尿道上裂或尿道下裂的隐匿性阴茎患儿,在行隐匿性阴茎矫正术的同时应行尿道上裂或尿道下裂修复术,通常手术治疗效果良好,术后并发症少。Objective To explore the surgical treatments and efficacies of concealed penis(CP)children with urethral deformity.Methods From January 2019 to March 2023,the relevant clinical data were retrospectively reviewed for 17 CP children with urethral deformity.After intraoperative exploration and reversal,there were epispadias(n=6)and hypospadias(n=11).They underwent repair of epispadias or hypospadias and penile exposure.The complications of wound infection,fistula,stenosis and recurrence of dorsiflexion or downward curvature were recorded.Results All operations were successfully completed.One case of hypospadias had fistula after removing catheter and one case of epispadias developed wound infection and dehiscence post-operation.Re-operation was performed for urethral fistula repair and urethroplasty.Postoperative outpatient follow-up period was(6-36)month.Appearance correction and postoperative recovery were excellent and their parents were satisfied with operative outcomes.Mean urinary flow rate was(10.53±2.22)ml/s in children with epispadias and(10.45±2.88)ml/s in those with hypospadias.There was no stenosis or fistula and spontaneous urination normalized.Conclusions For CP children with epispadias or hypospadias,simultaneous repair of epispadias or hypospadias may be performed along with correcting CP.Postoperative complications are fewer and operative outcomes decent.

关 键 词：隐匿性阴茎 尿道上裂 尿道下裂 诊断 治疗 

分 类 号：R69[医药卫生—泌尿科学]