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目的探讨采用分期手术治疗会阴型尿道下裂,行阴茎、阴囊矫形、重建缺损尿道的临床效果。方法22例会阴型尿道下裂采用分期手术：一期手术将阴茎海绵体完全伸直,阴茎包皮内板和背侧皮肤预置于阴茎腹侧和阴囊裂缝凹陷处；二期手术重建阴茎尿道采用半环状阴茎皮岛+半环状膀胱黏膜丛行侧面缝合形成阴茎尿道,阴囊尿道采用一期预置的组织丛行卷曲侧侧缝合重建阴囊尿道,在两尿道的接合点端端吻合,同时施行阴囊矫形。结果22例会阴型尿道下裂矫形后几乎接近正常状态,重建阴茎尿道长度为4—9 cm,平均7 cm。手术的成功率为68%(15．／22),尿瘘发生率为32%(7/22),5例(5/22)发生阴茎阴囊尿道交界处狭窄,经尿道扩张治疗后痊愈。结论会阴型尿道下裂行分期手术治疗可以修复超过10cm长的缺损尿道,而且完成手术以后外形形态较好。
Objective To investigate the clinical effect of staging surgery for perineal hypospadias, penile and scrotum reconstruction and reconstruction of defect urethra. Methods Twenty-two cases of perineal hypospadias were treated by staging. The first stage of operation was to completely extend the penis, the preputial plate of the penis and the dorsal skin were placed in the ventral penis and the scrotum of the scrotum. The second stage of operation was used to reconstruct the penis and urethra Semi-circular penis island + semi-circular bladder mucosa along the lateral line of the suture to form the penis urethra, scrotum urethra using a preset tissue curling lateral scrotal reconstruction of the scrotum urethra in the two urethral junction end anastomosis, at the same time The implementation of scrotum orthopedic. Results Twenty-two cases of perineal hypospadias were nearly normal after orthopedic reconstruction. The length of the penile urethra reconstructed was 4-9 cm with an average of 7 cm. The success rate of operation was 68% (15/22). The incidence of urinary fistula was 32% (7/22). In 5 cases (5/22), the penis scrotal urethral stricture junction was stenosed. After urethral dilatation, it cured. Conclusion The perineal surgical treatment of vulva hypospadias can repair the defect urethra more than 10cm in length, and the shape of the perineal hypospadias is better after the operation.