【摘要】 目的 探讨尿道板纵切卷管尿道成形术(TIP)结合下唇黏膜嵌入阴茎头段尿道板修复小阴茎头型尿道下裂合并患者的手术方法及疗效。方法 2010年5月至2014年7月收治无手术史尿道下裂并小阴茎头患者39例,其中冠状沟型3例,阴茎体前型20例,阴茎体中间型9例,阴茎体后型5例,阴茎阴囊交界型2例。年龄2.2~13.3岁,平均5.7岁。把阴茎头段尿道纵行切开并向两侧游离使可转移至腹侧,切取宽约0.6~1.0cm下唇黏膜嵌入尿道板做阴茎头段尿道背侧,再将尿道板卷管成形尿道。结果 所有患者均随访,随访6~25个月,平均18个月。手术成功30例(76.9%),发生尿道狭窄4例(10.25%)、尿瘘3例(7.69%)、尿道外口回缩2例(5.12%)。经处理除尿道狭窄中2例和尿道外口回缩2例成为冠状沟型尿道下裂(10.25%)外,余35例接近正常的阴茎外观。所有患者口腔言语、进食功能无影响,无口腔麻木、疼痛和外观不良等并发症。结论 对于尿道下裂合并小阴茎头患者,采用TIP结合下唇黏膜嵌入尿道板修复能有效解决阴茎头成形困难,手术效果满意,术后外观良好。更多还原

【Abstract】 Objeetive To investigate clinical effects of tubularized incised plate procedure combine with lower lip mucous in repairing hypospadias with small glans penis.Methods From 2010 to 2014,a total of 39 cases of hypospadias with small glans penis were enrolled in the study including 3 cases with coronal hypospadias,34 cases with penile hypospadias and 2 cases with penoscrotal hypospadias.For surgical procedure,a longitudinal incision was made in the urethra located in middle glans penis,and the incision was ditached extensively to make a tension-free around supporting tubes,then 0.6-1cm wide lower lip mucous was cut down to embeded in the incision.After that,using the tubularized incised plate urethroplasty(TIP).Results During 6~25 months following up,30 cases were cured successfully and voided influently,and other patients suffered from urethral stricture(4 case),urinary fistula(3 cases),and retraction of external urethral orifice(2 cases).2 cases with external orifice stricture and 2 cases with external orifice retraction of urethra were underwent second surgery into coronal hyposp-adias,35 patients had normal-appearing of penis.All patients had no any oral operative complication.Conclusion Tubularized incised plate procedure combine with lower lip mucous is effective for repairing hypospadias with small glans penis.更多还原