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成人阴茎段尿道缺损的修复

REPARATIVE TREATMENT OF URETHRAL DEFECT IN ADULT PENIS

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【作者】 李养群唐勇陈文周传德杨明勇李强王勇前刘新海李森恺

【Author】 LI Yangqun,TANG Yong,CHEN Wen, et al.Plastic Surgery Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing,100041,P.R.China

【机构】 中国医学科学院中国协和医科大学整形外科医院中国医学科学院中国协和医科大学整形外科医院 北京100041北京100041

【摘要】 目的总结成人阴茎段尿道缺损的手术修复方法及阴囊中缝区皮瓣的临床应用。方法2000年1月~2005年11月,对不同原因的阴茎段尿道缺损患者26例,年龄18~40岁,应用局部阴茎皮瓣再造缺损尿道,其中先天性阴茎型尿道下裂16例;外伤性阴茎中段尿道缺损6例,远段尿道缺损4例。外伤1~4年,曾行尿道造瘘术,反复尿道外口开大。应用以阴囊前、后动脉为蒂的阴囊中隔岛状皮瓣进行阴茎腹侧再造尿道表面创面的覆盖,皮瓣范围在阴囊中缝区宽2.5 cm,长5.5 cm内。结果术后除4例患者并发感染而漏尿,术后2~4周内自行愈合外,其余患者伤口均Ⅰ期愈合。术后随访7个月~4年,阴茎无弯曲,排尿无异常。结论应用阴茎局部皮瓣再造尿道及阴囊中缝区带蒂岛状皮瓣覆盖创面,是修复青春期后阴茎段尿道缺损一种良好的方法,手术操作简便,皮瓣血运可靠,修复后阴茎外形及功能均良好。

【Abstract】 Objective To summarize the methods of repairing the urethral defect in the penis of an adult and the clinical application of the island skin flaps of the scrotum septum to the reparative treatment.Methods From January 2000 to November 2005,twenty-six cases of urethral defect in penis,including 16 cases of congenital urethral defect,6 cases of traumatic urethral defect in middle penis,and 4 cases of distal urethral defect,were repaired by the local penis fascia flaps.The island skin flaps of the scrotum septum were transferred to cover the penis wound.The pedicle contained the artery of the posterior scrotum and the artery of the anterior scrotum.The flap taken from the scrotum septum was 2.5 cm×5.5 cm in area.Results After a follow-up of 7 months to 4 years,all the 26 patients had the healing of the first intention without urethral fistula,urethral narrowness or penis curvature,except 4 patients who developed infection and leakage of urine,but the wounds healed spontaneously 2-4 weeks after operation.Conclusion The penis fascia flaps and the island skin flaps of the scrotum septum can be used to repair the urethral defect in the penis of an adult.The blood supply to the flaps is sufficient and all the flaps can survive well.A good shape and function of the penis can be obtained.

【基金】 卫生部临床重点学科基金资助项目(20010409)
  • 【文献出处】 中国修复重建外科杂志 ,Chinese Journal of Reparative and Reconstructive Surgery , 编辑部邮箱 ,2006年12期
  • 【分类号】R699
  • 【被引频次】3
  • 【下载频次】93
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