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目的探讨Ⅱ期原位皮瓣尿道成型术治疗阴茎阴囊型尿道下裂的临床疗效,提高先天性尿道下裂患者的手术治疗水平。方法将2011年1月至2016年1月收治的26例阴茎阴囊型尿道下裂患者采取Ⅰ期阴茎伸直,包皮行阴茎腹侧皮瓣转移,6个月后行Ⅱ期原位皮瓣尿道成型术治疗尿道下裂。结果 26例患者中2例出现尿道狭窄,经规律尿道扩张后排尿症状改善;1例出现吻合口尿瘘,6个月后修补成功;所有病例均随访2~3年,排尿通畅,疗效满意。结论原位皮瓣尿道成形,保证了成形尿道血供,降低了吻合口张力,具有损伤小,术后水肿轻,尿瘘、尿道狭窄发生率较低等优点,可有效提高手术疗效。
Objective To investigate the clinical efficacy of phase Ⅱ orthotopic skin flap urethroplasty in the treatment of penile scrotum hypospadias and to improve the surgical treatment of congenital hypospadias. Methods Twenty-six patients with penile scrotal hypospadias treated from January 2011 to January 2016 were treated with stage Ⅰ penile extension and foreskin with penile ventral flap. After 6 months, stage Ⅱ primary urethral flap Shaping surgery to treat hypospadias. Results Urinary tract stenosis occurred in 2 of 26 patients. Urinary symptoms improved after regular urethral dilation. Anastomotic fistula was found in 1 case and repaired after 6 months. All cases were followed up for 2 to 3 years with smooth voiding and satisfactory curative effect. Conclusions The in-situ flap urethroplasty can ensure the blood supply of the formed urethra, reduce the anastomotic tension, have the advantages of less damage, less postoperative edema, lower incidence of urinary fistula and urethral stricture, which can effectively improve the curative effect.