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目的:探讨尿道板瓣在尿道成形中的价值,提高先天性尿道下裂的一次手术成功率。方法:将残余尿道粘膜及粘膜下组织一起形成尿道板瓣,与一侧包皮岛状瓣结合形成缺损段尿道,转移另一侧包皮瓣完成阴茎腹侧创面覆盖,尿道板瓣最大面积为2.0cm×0.5cm。治疗先天性阴茎型尿道下裂患者34例。结果:本组患者除3例患者术后出现尿道外口包皮瓣部分坏死,尿道外口狭窄,二次手术切开外,余者均Ⅰ期愈合,随访1～3年,无再造尿道狭窄及尿瘘等并发症出现。结论:先天性尿道下裂患者残余尿道粘膜及粘膜下组织可以形成具有良好血供的尿道板瓣,有效地解决了一侧包皮瓣再造尿道组织量不足的问题,提高了一次手术成功率。
Objective: To investigate the value of urethral plate flap in urethroplasty and to improve the success rate of one operation of congenital hypospadias. Methods: The residual urethral mucosa and submucosal tissue together to form the urethral plate flap, with one side of the island flap to form a defect segment of the urethra, the other side of the transfer flap to complete the penis ventral wound coverage, urethral plate maximum area of 2.0 cm × 0.5cm. 34 cases of congenital penile hypospadias. Results: All the patients except the three cases had partial necrosis of the external urethral flap and urethral stricture and secondary incision in 3 patients. All the patients were cured at first stage. No recurrence of urethral stricture And urinary fistula and other complications appear. CONCLUSION: Residual urethral mucosa and submucosal tissue of patients with congenital hypospadias can form urethral flap with good blood supply, which effectively solves the problem of insufficient urethral tissue regeneration with one side flap and improves the success rate of one operation.