摘要
尿道下裂是小儿泌尿外科常见的先天性畸形之一,其中因近端型矫治难度大、术后并发症多而成为手术治疗的难点。主流的修复策略主要包括一期与二期两种手术方式,学界对此尚存争议。现有循证证据提示,二期修复在降低尿道瘘、尿道狭窄等并发症方面具有优势。然而,随着一期修复术式的创新,可在保证低并发症发生率的同时减少手术次数,缩短康复周期,并减轻家庭负担。影响术式选择的关键因素包括尿道板是否保留、阴茎弯曲程度、是否合并阴茎阴囊转位畸形及术者的经验等。近端型尿道下裂的修复策略应多维度进行评估,合理选择一期或二期修复。
Hypospadias is one of the most common congenital anomalies in pediatric urology,and the proximal subtype remains particularly challenging because of technical difficulty and higher postoperative complication rates.The mainstream surgical approaches are one-stage and two-stage repairs,and debate persists regarding their optimal use.Current evidence suggests that two-stage repair offers advantages in reducing complications such as urethral fistula and urethral stricture.However,with ongoing innovations in one-stage techniques,it is possible to maintain low complication rates while reducing the number of operations,shortening recovery time,and lessening the burden on families.Key determinants of strategy selection include whether the urethral plate can be preserved,the degree of penile curvature,the presence of penoscrotal transposition,and the surgeon's experience.In proximal hypospadias,strategy selection should be guided by a multidimensional assessment to rationally choose between one-stage and two-stage repair.
作者
周辉霞
易小钰
ZHOU Huixia;YI Xiaoyu(Senior Department of Pediatrics,Chinese PLA General Hospital,Beijing,100700,China)
出处
《临床泌尿外科杂志》
2025年第11期943-946,共4页
Journal of Clinical Urology
关键词
近端型尿道下裂
一期修复
二期修复
proximal hypospadias
single-stage repair
two-stage repair
