Tang Yunman, Wang Xuejun, Mao Yu, Chen Shaoji, Liu Mao, Chen Yuejiao
Department of Pediatric Surgery of Children's Medical Center, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu Sichuan, 610072, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 May 8;30(5):594-598. doi: 10.7507/1002-1892.20160120.
To explore the surgical outcome of Duckett urethroplasty-urethrotomy for staged hypospadias repair.
Fifty-three patients with hypospadias were treated by 2 stages between August 2013 and September 2014. The age ranged from 10 months to 24 years and 3 months (median, 1 year and 10 months). There were 5 cases of proximal penile type, 2 cases of penoscrotal type, 36 cases of scrotal type, and 10 cases of perineal type. Urethroplasty was performed with tubed transverse preputial island flap only in 27 cases or combined with urethral plate in the other 26 cases, thus a urethrocutaneous fistula was intentionally created; stage II fistula repair was carried out at 1 year after stage I repair.
The length of the new urethra ranged from 2 to 8 cm with an average of 3.6 cm. The patients were followed up 5-17 months with an average of 8 months after stage II repair. After stage I repair, urethral fistula was noted at other site in 3 cases, skin necrosis in 1 case, glandular stricture in 2 cases, cicatric curvature in 1 case, and position and morphology of urethral orifice not ideal in 4 cases. After stage II repair, urethral fistula was noted in 2 cases, mild urethral diverticulum in 2 cases, and stricture at temporary repair site in 1 case. HOSE score was 12-16 at 3 months after stage II repair (mean, 14.5). At 3-14 months after stage II repair, the maximum flow rate ranged from 3.9 to 22.7 mL/s with an average of 8.6 mL/s.
Duckett urethroplasty-urethrotomy can be used as staged repair for primary treatment of hypospadias because of high safety, low complication incidence, and satisfactory appearance.
探讨Duckett尿道成形术-尿道切开术分期修复尿道下裂的手术效果。
2013年8月至2014年9月期间，对53例尿道下裂患者分两期进行治疗。年龄范围为10个月至24岁3个月（中位数为1岁10个月）。阴茎近端型5例，阴茎阴囊型2例，阴囊型36例，会阴型10例。仅27例采用带蒂横行包皮岛状皮瓣行尿道成形术，另外26例联合尿道板行尿道成形术，故意制造尿道皮肤瘘；一期修复术后1年进行二期瘘修补术。
新尿道长度为2～8cm，平均3.6cm。二期修复术后对患者进行了5～17个月的随访，平均随访8个月。一期修复术后，3例出现其他部位尿道瘘，1例皮肤坏死，2例腺体狭窄，1例瘢痕挛缩性阴茎弯曲，4例尿道口位置及形态不理想。二期修复术后，2例出现尿道瘘，2例出现轻度尿道憩室，1例临时修复部位狭窄。二期修复术后3个月HOSE评分为12～16分（平均14.5分）。二期修复术后3～14个月，最大尿流率为3.9～22.7mL/s，平均8.6mL/s。
Duckett尿道成形术-尿道切开术可作为尿道下裂一期治疗的分期修复方法，因其安全性高、并发症发生率低且外观满意。
