Yu Bin, Zhou Juan, Wang Zhong, Cai Zhi-Kang, Dong Guo-Qin, Jiang Yue-Qing, Jiang Hua
Department of Urology, The Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Zhonghua Nan Ke Xue. 2009 Jan;15(1):12-5.
To study the clinical effect of Duckett's procedure of one-stage urethroplasty with the transverse preputial island flap in the treatment of hypospadias.
We retrospectively studied 20 cases of hypospadias treated by Duckett's procedure of one-stage urethroplasty with the transverse preputial island flap (Group A) from 2003 to 2007. The patients ranged in age from 2 to 22 years (mean 11.3 years). Another 30 hypospadias patients aged 7 to 34 (mean 16.1) years underwent urethroplasty with mucous membrane of the bladder (Group B) in the same period. Of the 50 cases, 13 were the penile type, 33 the penoscrotal type, 2 the scrotal type, and 2 the perineal type. Catheters were indwelled in Group A, but both cystostomy and catheter indwelling were used in Group B.
For Duckett's procedure, surgery succeeded in 17 cases (85%), urethra stenosis developed in 1 (5%) and urinary fistula in 2 (10%), which were successfully repaired 6 months after the operation. The mean operation frequency was 1.1 per patient. In Group B, the operation was accomplished in 2 stages and succeeded in 26 cases (86.7%), with postoperative development of urinary fistula in 3 (10%) and urethra stenosis in 1 (3.3%). The mean operation frequency was 2.1 per patient. The 2 cases of postoperative urethra stenosis were both cured by urethral sounding.
Duckett's procedure of one-stage urethroplasty with the transverse preputial island flap is effective in hypospadias repair, with a success rate close to that of other types of operations and a low rate of postoperative complications. Compared with the use of mucous membrane of the bladder, it has the advantages of one-move accomplishment and gives a better penile appearance.
探讨采用横行包皮岛状皮瓣一期尿道成形术（Duckett术）治疗尿道下裂的临床效果。
回顾性分析2003年至2007年采用横行包皮岛状皮瓣一期尿道成形术（Duckett术）治疗的20例尿道下裂患者（A组）。患者年龄2至22岁（平均11.3岁）。同期另30例年龄7至34岁（平均16.1岁）的尿道下裂患者采用膀胱黏膜尿道成形术（B组）。50例患者中，阴茎型13例，阴茎阴囊型33例，阴囊型2例，会阴型2例。A组留置导尿管，B组采用膀胱造瘘及留置导尿管。
Duckett术手术成功17例（85%），尿道狭窄1例（5%），尿瘘2例（10%），术后6个月均成功修复。平均每位患者手术次数为1.1次。B组手术分两期完成，成功26例（86.7%），术后尿瘘3例（10%），尿道狭窄1例（3.3%）。平均每位患者手术次数为2.1次。2例术后尿道狭窄均经尿道扩张治愈。
采用横行包皮岛状皮瓣一期尿道成形术（Duckett术）修复尿道下裂效果良好，成功率与其他术式相近，术后并发症发生率低。与膀胱黏膜尿道成形术相比，具有一次完成手术的优点，阴茎外观更佳。
