摘要
目的评价阴茎腹外侧皮瓣在尿道成形中的作用。方法根据解剖特点设计一个含畸形尿道海绵体的阴茎腹外侧皮瓣。横断短缩的尿道板以彻底矫直阴茎，尿道板缺损段移植颊黏膜或包皮内板皮片，与皮瓣耦合成形尿道，Ⅰ期修复原发阴茎阴囊型尿道下裂。结果本组共16例患者。所用阴茎腹外侧皮瓣均血供良好、长宽足够、术后无坏死。移植组织7例为颊黏膜，9例为包皮内板皮肤。术后并发症包括尿道口狭窄2例（12．5％）和尿道口腹侧小块组织坏死而遗留大口型尿道下裂1例（6．25％）。余患者Ⅰ期治愈，无并发症，术后随访0．5～2．0年，阴茎无弯曲，外观良好，尿道开口正位。结论应用腹外侧皮瓣耦合移植组织成形尿道有利于阴茎矫直，术后尿道瘘及狭窄发生率低，是修复阴茎阴囊型尿道下裂的较好术式。
Objective To evaluate the effect of ventral-lateral penile skin flap in urethroplasty. Methods While performing single-stage procedure for penoscrotal hypospadias, a ventral-lateral penile skin flap including abnormal corpus spongiosum that beneath it was formed according to its anatomical characteristic, the urethral plate was transected to complete penile straightening, the plate defect was corrected by buccal mucosa or inner foreskin grafting. The neourethra was constructed with a combination of the flap, the plate, and the graft. Results Totally 16 patients were included. The flap was well vascularized and wide enough, long enough for urethroplasty, no flap necrosis occurred postoperatively. Buccal mucosa and inner foreskin grafting were performed in 7 and 9 cases, respectively. Complications were meatus stricture in 2 cases and necrosis of small piece of ventral glanular tissue in 1 case. The former demanded second operation; the latter resulted in a me- gameatus. The remaining cases were cured without complications. All patients were followed for 0.5 to 2.0 years, penile appearance was well, no residual chordee. Conclusion The combining method for urethroplasty, which facilitating chordee correction without increasing the incidence of urethral fistula and stricture, is appropriate for penoscrotal hypospadias surgery.
出处
《中国美容整形外科杂志》
CAS
2013年第6期337-340,共4页
Chinese Journal of Aesthetic and Plastic Surgery
基金
国家科技支撑计划项目（2006BA105A06）
北京协和医学院创新基金项目（5201020104）
关键词
尿道下裂
尿道成形术
尿瘘
尿道狭窄
Hypospadias
Urethroplasty
Urethrocutaneous fistula
Urethral stricture
