不同术式治疗尿道下裂48例体会

王胜利; 杨大强; 张端卫; 孙毅伦

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不同术式治疗尿道下裂48例体会

王胜利 , 杨大强 , 张端卫 , 孙毅伦

文章导航 > 蚌埠医学院学报 > 2011, 36 > 6: (612-614)

引用本文:

Citation:

不同术式治疗尿道下裂48例体会

安徽省蚌埠市第三人民医院泌尿外科, 233000

作者简介: 王胜利(1975-),男,主治医师.

中图分类号: R695

Different surgical procedures for hypospadia:a report of 48 cases

Department of Urology, Bengbu Third People's Hospital, Bengbu Anhui 233000, China
CLC number: R695

摘要: 目的: 总结不同术式治疗先天性尿道下裂的疗效及并发症情况,为尿道下裂患者选择最佳治疗术式提供临床依据。方法: 对48例尿道下裂患者采用不同术式修复,其中Duckett术式23例,Denis-Browne术式3例,Duplay术式10例,MAGPI术式1例,Duckett+Duplay (联合皮管)术式3例,阴囊纵隔皮瓣术式3例,Hodgson术式5例;总结各种手术方式的成功率及相关并发症。结果: Duckett术式一期成功18例,尿瘘3例,吻合口狭窄1例,皮缘坏死1例;Denis-Browne术式成功2例,尿道狭窄1例;Duplay术式成功7例,尿瘘3例;MAGPI术式成功1例;Duckett+Duplay术式成功1例,尿瘘1例、吻合口狭窄1例;阴囊纵隔皮瓣术式成功2例,尿瘘1例;Hodgson术式成功4例,尿瘘1例。结论: 应根据阴茎大小、尿道口位置、背侧包皮多少及有无阴茎下曲来选择相应的手术方式。对于首次接受治疗的多数尿道下裂患者,带蒂包皮瓣卷管术式(Duckett、Hodgson等)可作为首选;阴茎下曲矫正术后二期手术患者,可选择Duplay、Denis-Browne等术式;多次手术失败或外生殖器皮源匮乏的患者应考虑采用游离组织(膀胱黏膜、颊黏膜、舌黏膜等)替代治疗。
- 尿道下裂 /
- 尿道成形术 /
- 尿道狭窄 /
- 尿瘘
Abstract: Objective: To observe and summarize the therapeutic effects and complications of different surgical procedures for treatment of hypospadia so as to provide basis for patients to choose a suitable pattern. Methods: Different surgical procedures were applied to 48 patients with hypospadia. Duckett was adopted by 23 cases,Denis-Browne 3 cases,Duplay 10 cases,MAGPI 1 case, Duckett + Duplay 3 cases,scrotal septal vascular pediclen flap 3 cases and Hodgson 5 cases. The success rate and the complication of each procedure were analyzed retrospectively. Results: Of the 23 cases treated by Duckett,one-stage success was achieved in 18 cases, urinary fistula occurred in 3 cases,anastomotic stricture in one case and skin edge necrosis in one case; of the 3 cases treated by DenisBrowne,2 cases achieved successful results and 1 developed urethral stricture; of the 10 cases adopting Duplay,one-stage success was achieved in 7 cases and urinary fistula occurred in 3 cases; the operation was successful in the one case treated by MAGP; of the 3 cases adopting Duckett + Duplay,the operation was successful in 1 case,urinary fistula occurred in 1case and anastomotic stricture in 1 case; of the 3 cases treated by scrotal septal vascular pediclenflap,successful result was achieved in 2 cases and urinary fistula occurred in one case; of the 5 cases adopting Hodgson,4 cases achieved good results and urinary fistula occurred in 1 case. Conclusions: Different surgical procedures should be applied to different types of hypospadia. To most patients receiving the therapy for the first time,Duckett and Hodgson procedures should be taken as the first choice; patients receiving the penis diorthosis surgery for the second time may choose Duplay or Denis-Browne; patients having experienced failed operations or lacking external genital organ skin source should consider using dissociation substitution tissues(cheek mucous membrane,tongue mucous membrane and so on).
- hypospadias /
- urethroplasty /
- urethral stricture /
- urethral fistula

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[2]	朱巍 , 杨登伦 , 任春凯 , 乙从亮 , 余秋健 , 陈令秋 , 唐喆 , 黄斌 . 尿道板纵切卷管尿道成形术治疗尿道下裂32例临床分析. 蚌埠医学院学报, 2012, 36(5): 548-550.
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[4]	徐挺 , 李庆文 , 韩锋 . 两种不同术式一期修复尿道下裂的疗效比较. 蚌埠医学院学报, 2011, 36(5): 471-473.
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[6]	刘彬 , 单卫民 , 杜永强 , 徐自立 . 腔内手术与开放性手术治疗尿道狭窄的疗效分析. 蚌埠医学院学报, 2006, 31(5): 527-528.
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不同术式治疗尿道下裂48例体会

作者简介: 王胜利(1975-),男,主治医师.

安徽省蚌埠市第三人民医院泌尿外科, 233000

收稿日期: 2010-08-02

关键词:

摘要: 目的: 总结不同术式治疗先天性尿道下裂的疗效及并发症情况,为尿道下裂患者选择最佳治疗术式提供临床依据。方法: 对48例尿道下裂患者采用不同术式修复,其中Duckett术式23例,Denis-Browne术式3例,Duplay术式10例,MAGPI术式1例,Duckett+Duplay (联合皮管)术式3例,阴囊纵隔皮瓣术式3例,Hodgson术式5例;总结各种手术方式的成功率及相关并发症。结果: Duckett术式一期成功18例,尿瘘3例,吻合口狭窄1例,皮缘坏死1例;Denis-Browne术式成功2例,尿道狭窄1例;Duplay术式成功7例,尿瘘3例;MAGPI术式成功1例;Duckett+Duplay术式成功1例,尿瘘1例、吻合口狭窄1例;阴囊纵隔皮瓣术式成功2例,尿瘘1例;Hodgson术式成功4例,尿瘘1例。结论: 应根据阴茎大小、尿道口位置、背侧包皮多少及有无阴茎下曲来选择相应的手术方式。对于首次接受治疗的多数尿道下裂患者,带蒂包皮瓣卷管术式(Duckett、Hodgson等)可作为首选;阴茎下曲矫正术后二期手术患者,可选择Duplay、Denis-Browne等术式;多次手术失败或外生殖器皮源匮乏的患者应考虑采用游离组织(膀胱黏膜、颊黏膜、舌黏膜等)替代治疗。

English Abstract

Different surgical procedures for hypospadia:a report of 48 cases

Department of Urology, Bengbu Third People's Hospital, Bengbu Anhui 233000, China

Received Date: 2010-08-02

Abstract: Objective: To observe and summarize the therapeutic effects and complications of different surgical procedures for treatment of hypospadia so as to provide basis for patients to choose a suitable pattern. Methods: Different surgical procedures were applied to 48 patients with hypospadia. Duckett was adopted by 23 cases,Denis-Browne 3 cases,Duplay 10 cases,MAGPI 1 case, Duckett + Duplay 3 cases,scrotal septal vascular pediclen flap 3 cases and Hodgson 5 cases. The success rate and the complication of each procedure were analyzed retrospectively. Results: Of the 23 cases treated by Duckett,one-stage success was achieved in 18 cases, urinary fistula occurred in 3 cases,anastomotic stricture in one case and skin edge necrosis in one case; of the 3 cases treated by DenisBrowne,2 cases achieved successful results and 1 developed urethral stricture; of the 10 cases adopting Duplay,one-stage success was achieved in 7 cases and urinary fistula occurred in 3 cases; the operation was successful in the one case treated by MAGP; of the 3 cases adopting Duckett + Duplay,the operation was successful in 1 case,urinary fistula occurred in 1case and anastomotic stricture in 1 case; of the 3 cases treated by scrotal septal vascular pediclenflap,successful result was achieved in 2 cases and urinary fistula occurred in one case; of the 5 cases adopting Hodgson,4 cases achieved good results and urinary fistula occurred in 1 case. Conclusions: Different surgical procedures should be applied to different types of hypospadia. To most patients receiving the therapy for the first time,Duckett and Hodgson procedures should be taken as the first choice; patients receiving the penis diorthosis surgery for the second time may choose Duplay or Denis-Browne; patients having experienced failed operations or lacking external genital organ skin source should consider using dissociation substitution tissues(cheek mucous membrane,tongue mucous membrane and so on).