Fu Qiang, Deng Chen-Liang
Department of Urology, Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China.
Urology. 2006 Jun;67(6):1274-7; discussion 1277. doi: 10.1016/j.urology.2005.12.048.
A variety of surgical techniques and flaps have been described for hypospadias repair. We present our 10-year experience using a composite urethroplasty graft consisting of bladder mucosa and skin.
We reviewed the records of 294 patients who had undergone hypospadias repair at our institution from 1993 to 2003. The meatus was penile in 221, penoscrotal in 55, and perineal in 18. They all underwent single-stage urethroplasty consisting of a composite tubularized bladder mucosa-skin graft. Patient age at surgery was 2 to 46 years old (mean 8.9).
Urethrocutaneous fistula formation occurred in 27 (9.1%) and urethral strictures in 9 (3.2%), for an overall complication rate of 12.3%. No proximal urethral anastomotic strictures or meatal stenosis developed.
Our results have demonstrated that composite bladder mucosa-skin flap grafts can be used successfully for urethral reconstruction in proximal, as well as distal, hypospadias repair. The distal tubularized skin flap prevented the occurrence of meatal stenosis.
已有多种手术技术和皮瓣用于尿道下裂修复。我们介绍了我们使用由膀胱黏膜和皮肤组成的复合尿道成形术移植物的10年经验。
我们回顾了1993年至2003年在我们机构接受尿道下裂修复的294例患者的记录。尿道口位于阴茎的有221例，阴茎阴囊的有55例，会阴的有18例。他们均接受了由复合管状膀胱黏膜-皮肤移植物组成的一期尿道成形术。手术时患者年龄为2至46岁（平均8.9岁）。
尿道皮肤瘘形成27例（9.1%），尿道狭窄9例（3.2%），总并发症发生率为12.3%。未发生近端尿道吻合口狭窄或尿道口狭窄。
我们的结果表明，复合膀胱黏膜-皮肤皮瓣移植物可成功用于近端及远端尿道下裂修复的尿道重建。远端管状皮肤皮瓣可防止尿道口狭窄的发生。
