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目的探索一种能有效防止术后尿道狭窄、尿瘘的一期尿道下裂修复技术。方法彻底矫直阴茎下弯畸形之后,即时在裂隙两侧缘形成2条适当宽度的阴茎浅动脉腹外侧支岛状筋膜皮瓣再造尿道。经隧道或剖开龟头,将尿道置于适当位置并开口于龟头远端。用阴囊中隔皮瓣旋转180°,覆盖阴茎腹侧创面,一次手术完成尿道下裂修复。结果修复阴茎阴囊型尿道下裂13例,再造的尿道及转移的阴囊皮瓣均100%成活,手术一次成功。随诊6个月～8年,13例均无尿道狭窄或尿瘘发生,阴茎完全挺直,排尿在龟头远端,尿路通畅成线。尿道吻合口处发生憩室1例。结论实施该技术的一期尿道下裂修复术,具有防瘘及成功率高之优点,可供临床医师选用。
Objective To explore a technique to effectively prevent postoperative urethral stricture and urinary fistula repair of hypospadias. Methods After the penile deformity was completely straightened, two urethral reformation urethral vessels were formed on the lateral flaps of the penis. The tunnel or cut the glans, urethra placed in place and opened in the distal glans. Scrotal septum flap rotated 180 °, covering the penis ventral wounds, a surgery to complete hypospadias repair. Results Repair penis scrotum hypospadias in 13 cases, reconstruction of the urethra and metastatic scrotal flap were 100% survived, the operation was successful. Follow-up 6 months to 8 years, 13 cases were no urethral stricture or urinary fistula occurred, the penis is completely straight, urination at the distal glans, urinary tract open into a line. One case of diverticulum occurred at the anastomotic urethra. Conclusion The implementation of the technique of a hypospadias repair, with the advantages of high fistula and success rate, available to clinicians.