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目的探讨复杂尿道下裂的治疗以及术后尿道狭窄的预防。方法从2005年5月至2005年10月,我们在Snodgrass尿道成形术基础上,通过将游离的自体唇黏膜瓣镶嵌于劈开的“尿道板”再卷管形成新尿道的方法对23例经过至少1次手术的复杂尿道下裂病例进行再次手术治疗并评价其效果。结果所有病例术后均无明显的尿道狭窄,尿瘘发生率17.4%(4/23)。无尿道憩室形成和尿道口黏膜增生外翻。结论镶嵌式唇黏膜尿道成形术兼有Snodgrass尿道成形术和游离移植物代尿道成形术的优点,是治疗尿道下裂合并尿道狭窄的有效方法;对于尿道板发育不良或经阴茎伸直术后的重度尿道下裂病例,镶嵌唇黏膜具有预防尿道狭窄的作用。
Objective To investigate the treatment of complex hypospadias and the prevention of postoperative urethral stricture. Methods From May 2005 to October 2005, on the basis of Snodgrass urethroplasty, we established a new urethra by inserting a free self-lip labial flap into a split “urethral plate” At least one operation complicated case of hypospadias re-operation and evaluation of the results. Results No cases of urethral stricture were found in all cases. The incidence of urinary fistula was 17.4% (4/23). No urethral diverticulum formation and urethral mucosa hyperplasia valgus. Conclusions Mosaic lip mucosa urethroplasty has both the advantages of Snodgrass urethroplasty and free-graft urethroplasty and is an effective method for the treatment of hypospadias with urethral stricture. For urethral plate dysplasia or penile extension Severe cases of hypospadias, inlaid lip mucosa with the role of prevention of urethral stricture.