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1986年以来,我院采用多种术式修复尿道下裂,其中应用膀胱粘膜一期修复尿道下裂18例,一次手术成功率达88.8%,现予以介绍.临床资料一、手术方法取半卧位,双下肢略外展,阴茎头穿丝线作牵引,按下述步骤进行:(1)如(图1)作切口,分离并切除尿道口两侧直至冠状沟处的挛缩性纤维组织,使尿道口回缩,阴茎完全伸直;(2)于龟头顶部切一小口,用纹式钳自小口向冠状沟两阴茎海绵体间戳孔,再用5号尿道探进行扩张,使之形成一隧道(图2);(3)测定回缩的尿道口与龟头顶端距离;(4)在膀胱造瘘的同时截取膀胱粘膜瓣,以备制作“替代尿道”,由于吻合尿道的需要及预防龟头口外部分粘膜的坏死,粘膜瓣的长度宜比实际测得的距离长1.0～1.5cm,(本组一般为5.0～7.0cm)其宽度根据所作尿道的直径0.5～0.6cm计算周长即可(本组一般
Since 1986, our hospital using a variety of surgical procedures to repair hypospadias, including the application of bladder mucosa in the first phase of repair hypospadias in 18 cases, a surgical success rate of 88.8%, are to be introduced.Clinical data First, the surgical approach to take half Bit, both lower extremities slightly abduction, the penis through the wire for traction, according to the following steps: (1) as (Figure 1) for incision, separation and removal of both sides of the urethra until the coronary sulcus contracture fibrous tissue Urethral retraction, completely straight penis; (2) at the top of the glans cut a small mouth, with a forceps from the small mouth to the coronal dural penis between the two penile sponges, and then No. 5 urinary tract exploration expansion to form a Tunnel (Figure 2); (3) determination of retraction of the urethra and glans penis tip distance; (4) in the bladder fistula at the same time interception of bladder mucosal flap in preparation for the production of “alternative urethra” due to the need to meet the urethra and prevent glans Oral mucosal necrosis, the length of the mucosal flap should be longer than the actual measured distance 1.0 ~ 1.5cm, (the group is generally 5.0 ~ 7.0cm) its width according to the urethral diameter of 0.5 ~ 0.6cm can calculate the perimeter ( This group is average