论文部分内容阅读
目的探讨25例成人先天性尿道下裂术后尿瘘的治疗方法及其效果,以期提高治疗水平。方法从1997年1月至2006年12月收治的25例成人先天性尿道下裂术后尿瘘患者,瘘口位于阴茎阴囊交界处10例,阴茎体部7例,冠状沟下8例;1个瘘口者7例,2个以上者18例。简单尿瘘(9例)采用Y-V成形或TIP术治疗,复杂尿瘘(16例)采用Mathieu法或TIP术或阴囊中隔尿道成形及肉膜蒂加盖术。结果术后随访6个月至2年,22例患者1次手术成功。结论充分的术前准备、选择正确的手术方法及尿道成形材料、充分有效的尿转流及术后细致的护理,是尿瘘修补成功的重要要素。阴茎无下曲、阴茎皮肤充裕、远端尿道尚可应用的尿瘘患者,采用Y-V成形或TIP术;远端尿道闭锁/狭窄或阴茎皮肤瘢痕多、皮肤不充裕伴阴茎下曲的患者,采用Mathieu法、TIP术或阴囊中隔尿道成形术,肉膜蒂加盖:均是行之有效的方法。
Objective To investigate the treatment of urinary fistula after 25 cases of congenital hypospadias and its effects in order to improve the therapeutic level. Methods From January 1997 to December 2006 in 25 cases of adult patients with urinary fistula after congenital hypospadias, the fistula was located in the junction of the penis and scrotum 10 cases, 7 cases of the penis, coronal groove in 8 cases; 1 7 cases of fistula, more than 2 in 18 cases. Simple urinary fistulas (n = 9) were treated with Y-V or TIP. Complicated urinary fistulas (n = 16) were treated with Mathieu’s or TIP or scrotal septum urethroplasty and petrosal pedicle. Results The patients were followed up for 6 months to 2 years. Twenty-two patients were successful in one operation. Conclusions Adequate preoperative preparation, proper operation and urethroplasty, adequate and effective urinary diversion, and meticulous care after operation are important factors in the success of urinary fistula repair. No penis genital penile, penile skin is sufficient, the distal urethra is still applicable urinary fistula patients, the use of YV forming or TIP; distal urethral atresia / stenosis or penile skin scarring, skin insufficiency with penile curvature patients, using Mathieu Law, TIP surgery or scrotal septoplasty, meningitis stamped: are effective methods.