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目的总结成人阴茎段尿道缺损的手术修复方法及阴囊中缝区皮瓣的临床应用。方法2000年1月~2005年11月,对不同原因的阴茎段尿道缺损患者26例,年龄18~40岁,应用局部阴茎皮瓣再造缺损尿道,其中先天性阴茎型尿道下裂16例;外伤性阴茎中段尿道缺损6例,远段尿道缺损4例。外伤1~4年,曾行尿道造瘘术,反复尿道外口开大。应用以阴囊前、后动脉为蒂的阴囊中隔岛状皮瓣进行阴茎腹侧再造尿道表面创面的覆盖,皮瓣范围在阴囊中缝区宽2.5 cm,长5.5 cm内。结果术后除4例患者并发感染而漏尿,术后2~4周内自行愈合外,其余患者伤口均Ⅰ期愈合。术后随访7个月~4年,阴茎无弯曲,排尿无异常。结论应用阴茎局部皮瓣再造尿道及阴囊中缝区带蒂岛状皮瓣覆盖创面,是修复青春期后阴茎段尿道缺损一种良好的方法,手术操作简便,皮瓣血运可靠,修复后阴茎外形及功能均良好。
OBJECTIVE: To summarize the surgical repair method of adult penile urethral defect and the clinical application of the scrotum midfacial zone flap. Methods From January 2000 to November 2005, 26 cases of urethral defect of penis segment with different causes were aged from 18 to 40 years old. The defect of the urethra was reconstructed with local penis flap, of which 16 cases were congenital penile hypospadias. Trauma Sexual penile urethra defect in 6 cases, distal urethral defect in 4 cases. Trauma 1 to 4 years, had urethral ostomy, repeated urethral orifice open large. Application of the scrotal septal island flap pedicled on the anterior and posterior arterial pedicle of the scrotum to cover the wound surface of the urethra on the ventral side of the penis. The flap range is 2.5 cm in length and 5.5 cm in the scrotum. Results All the patients had primary wound healing after 4 cases of patients had leakage of urine and 4 to 4 weeks after operation. Follow-up 7 months to 4 years after surgery, no penile curvature, urination no abnormalities. Conclusion The penile local flap reconstruction urethra and scrotum dorsal island flap covering the wound is a good method to repair the urethral defect of the penis segment after puberty. The operation is simple, the blood supply of the flap is reliable, and the shape of the penis after the repair Function is good.