Hayden L J, Koff S A
J Urol. 1984 Aug;132(2):311-2. doi: 10.1016/s0022-5347(17)49606-6.
Seven boys with short membranous urethral strictures were treated with a single stage perineal urethroplasty. Anterior urethral mobilization lengthened the urethra sufficiently for a bulboprostatic anastomosis free of tension and in no case was transpubic surgery required. The result was ultimately satisfactory for all children. Although the perineum is proportionately narrower in children than in adults, the depth of the membranous urethra from the skin level is reduced to an even greater degree. As a result exposure of the membranous urethra in children, particularly young children, often is easier than might be anticipated on the basis of imagined miniaturization of adult dimensions. We recommend an initial perineal approach for all short membranous urethral strictures in children with conversion to the transpubic approach if complications or a longer stricture is encountered.
7例患有短段膜部尿道狭窄的男孩接受了一期会阴尿道成形术治疗。前尿道游离术使尿道充分延长，足以进行无张力的球部-前列腺吻合术，无一例需要行经耻骨手术。最终所有患儿的结果均令人满意。尽管儿童会阴相对成人更窄，但从皮肤层面到膜部尿道的深度减小程度更大。因此，儿童尤其是幼儿的膜部尿道暴露往往比根据成人尺寸想象的缩小情况更容易预期。我们建议对所有儿童短段膜部尿道狭窄采用初始会阴入路，若遇到并发症或狭窄段更长，则改行耻骨入路。
