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目的:评价带蒂阴囊中隔皮瓣加盖睾丸鞘膜尿道成形术在失败尿道下裂手术中的应用,了解其适应证、手术方法、术后并发症及远期效果。方法:回顾性分析2008年1月~2013年12月采用带蒂阴囊中隔皮瓣加盖睾丸鞘膜尿道成形术治疗的43例手术失败的尿道下裂病例及随访资料,描述手术适应证、手术方法,总结术后并发症及处理方法,评价远期效果。结果:平均手术时间110min。术后并发症发生率为14%(6/43),其中尿道皮肤瘘3例,尿道憩室1例,尿道口狭窄2例。术后1年随访,阴茎外观满意率为90.7%(39/43),通过随诊观察排尿评估尿道功能正常率为95.35%(41/43)。5例尿道镜检查无明显毛石形成。结论:带蒂阴囊中隔皮瓣加盖睾丸鞘膜尿道成形术是在失败尿道下裂修复术中有效的手术方式,手术方法相对简单,容易掌握,手术并发症较少,远期效果确切。
Objective: To evaluate the application of pedicled scrotum septal flaps and testicular sheath urethroplasty in the failure of hypospadias surgery, and to find out its indications, surgical methods, postoperative complications and long-term effects. Methods: A retrospective analysis of 43 cases of failed hypospadias cases and follow-up data from January 2008 to December 2013 using pedicled scrotum septal flap sutured with testicular sheath urethroplasty was performed to describe the surgical indications, Surgical methods, summing up postoperative complications and treatment methods, evaluation of long-term results. Results: The average operation time was 110min. The incidence of postoperative complications was 14% (6/43), including 3 cases of urethral skin fistula, 1 case of urethral diverticulum and 2 cases of urethral stenosis. The satisfactory rate of penile appearance was 90.7% (39/43) after 1 year of follow-up. The urinary tract function normal rate was 95.35% (41/43). No urethra examination was found in 5 cases. CONCLUSIONS: The pedicled scrotum septal flap is sutured with testicular sheath urethroplasty and is an effective surgical approach in the repair of failed hypospadias. The surgical method is relatively simple and easy to grasp, with fewer complications and long-term results.