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目的:探讨尿道下裂术后再发尿瘘的各项相关因素在尿瘘修复的影响。方法:回顾性总结1997年1月～2008年6月收治的106例尿道下裂术后复发尿瘘患者临床资料。统计并分析尿瘘位置、瘘口大小、瘘口数目、尿瘘修补次数等相关观察指标,采用合适的术式进行尿瘘修补。结果:84例一次修复完成,一次手术成功率79.2%;22例再次出现尿瘘,其中1例同时并发尿道狭窄,需进一步治疗。不同的尿瘘位置与手术成功率差异无统计学意义(P>0.05),瘘口的大小、数目不影响手术成功率(P>0.05),术前修补的次数与手术成功率差异无统计学意义(P>0.05)。结论:尿瘘的位置、大小、数目和手术修补次数等因素不影响手术成功率。术前对患者的尿瘘位置、瘘口大小、瘘口数目及局部条件的不同需制定明确的方案。选择合适的术式及术中的精细操作是最重要的因素。
Objective: To investigate the influence of various factors related to the recurrence of urinary fistula in the repair of urinary fistula after hypospadias surgery. Methods: The clinical data of 106 patients with recurrent urinary fistula after hypospadias operation from January 1997 to June 2008 were retrospectively reviewed. Statistics and analysis of urinary fistula position, the size of the fistula, the number of fistula, the number of urinary fistula repair and other related indicators, the use of appropriate surgical fistula repair. Results: 84 cases completed a repair, a surgical success rate of 79.2%; 22 cases of urinary fistula again, including 1 case of simultaneous urethral stricture, need further treatment. There was no significant difference between the different urinary fistula position and operation success rate (P> 0.05). The size and number of fistula did not affect the success rate of operation (P> 0.05). There was no significant difference between the number of preoperative repair and operation success rate (P> 0.05). Conclusion: The location, size, number of the urinary fistula and the number of surgical repair do not affect the success rate of surgery. Preoperative urinary fistula position of patients, the size of the fistula, the number of fistula and the local conditions need to develop a clear solution. Select the appropriate surgical procedures and intraoperative fine operation is the most important factor.