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目的:探讨男性尿道异位开口于肛管的矫治方法和临床效果。方法:13例尿道异位开口于肛管的男性患者,6例伴睾丸位置异常,2例伴阴茎、阴囊异位。采用分期手术:一期手术行阴茎弯曲矫正,阴茎包皮内板和阴茎背筋膜皮瓣或游离口腔黏膜瓣预置于阴茎腹侧和阴囊处;二期手术将尿道从肛管处分离,采用一期预置组织重建尿道并在接合点行端端吻合,阴茎阴囊异位者行转位手术。结果:13例患者术后形态接近正常,重建尿道长度6-10.5cm,平均8.4cm,手术成功率69.2%(9/13),其中3例并发尿道皮肤瘘,1例尿道狭窄。结论:通过分期手术方式,可以将尿道从肛管完整分离并重建缺损尿道,恢复男性正常生理功能。
Objective: To explore the method and clinical effect of male urinary tract ectopic opening in the anal canal. Methods: Thirteen male patients with urethral ectopic opening in the anal canal, 6 with abnormal testicular position, 2 with penile and scrotum ectopic. Using staging surgery: a surgical correction of penile curvature, the penis foreskin and penile dorsal fascia flap or free oral mucosal flap preset in the ventral penis and the scrotum; second phase surgery to separate the urethra from the anal canal, using a Period of pre-tissue reconstruction urethra and anastomosis at the junction line ends, penis scrotum ectopic transposition surgery. Results: The shape of the urethra was almost normal after reconstruction. The urethral length was 6-10.5cm (mean 8.4cm). The successful rate of operation was 69.2% (9/13). Three cases had urethral skin fistula and one urethral stricture. Conclusion: By means of staging, urethra can be completely separated from the anal canal and the defect urethra can be reconstructed to restore the normal physiological function of the male.