重度长段尿道缺如尿道下裂Ⅰ期修复20例
尿道下裂；带血管蒂皮瓣；尿道成形术,,],尿道下裂；带血管蒂皮瓣；尿道成形术,[摘要],[关键词],1资料与方法,2结果,3讨论,[参考文献]
[摘要] 目的 探讨重度长段尿道缺如尿道下裂Ⅰ期修复术式。方法 采用近段尿道口基底蒂皮瓣翻转覆盖与保留的部分尿道板吻合成管加纵行带蒂岛状包皮瓣卷管成形尿道吻合即改良Onlay+Hodgson术式。20例重度长段尿道缺如尿道下裂伴阴茎弯曲者，尿道缺如以矫直阴茎后测量为8～12cm。成形尿道内留置多孔硅胶管支架引流尿液10天拔尿管排尿。结果 20例患者18例Ⅰ期成功修复正位排尿，外观满意，无臃肿扭转，1例尿瘘6个月后修补尿瘘痊愈，1例尿瘘孔小3个月后自愈；所有病例随访1年均无狭窄扭曲等并发症。结论 此方法修复重度长段尿道缺如尿道下裂，因该术式设计合理，保证成形尿道的蒂皮瓣具有良好的血供、效果确切、外观满意等优点，是一种较好的改良术式。[关键词] 尿道下裂；带血管蒂皮瓣；尿道成形术
Urethral agenesis and hypospadia by the first phase operation:A report of 20 cases
ZOU Liwen，WU Xuezhen，LI Wei，et al.Department of Urology,The First People’s Hospital of Zhaotong,Zhaotong 657000,China
[Abstract] Objective To explore the procedure of the first phase of repairing urethra crack by cutting deep and long into urethra.Methods Adopted the method of joining overturning surgical flap of nearby urethral orifice base and the remaining urethral plate by anastomosis longitudinal preputial tubular flap urethroplasty that is ameliorative Onlay+Hodgson operation carry out on 20 patients who suffered from urethra crack with clubbed penises by cutting deep and long into urethra.The operations straighten penises length is between 8~12cm.A cellular silicegel tube support is implanted and kept in the forming urethra to help drainage.Ten days later,the catheter can be drown and the patients can excrete urine normally.Results Eighteen of twenty cases succeeded in the first phase of repairing.The patients can excrete urine normally.The appearance of the urethra is satisfactory and no turnscent or crook happened.The other 2 patients,1 with urethra stoma recovered by reparing urinary fistula,the other with small urinary fistula was cured after 3 months.There were no any urethrostenosis or crook complicated.Conclusion The operation is used to repair urethra crack by cutting deep and long into urethra.The design of the operation is practical.The operation guarantees the forming urethra lie vascular pedicle can supply blood normally and has a good and obvious effect as well as the appearance is satisfactory.In a word,the method is a rather good ameliorative operation method. ......
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