不同术式修复尿道下裂5年诊治体会

J4 ›› 2015, Vol. 14 ›› Issue (2): 29-32.

不同术式修复尿道下裂5年诊治体会

大理学院附属医院，云南大理671000

收稿日期:2014-08-25 出版日期:2015-02-15 发布日期:2015-02-15
作者简介:文贵成，医师，主要从事泌尿外科研究.

The Five-year Experience of Using Different Surgical Treatments for Hypospadias

Affiliated Hospital of Dali University, Dali, Yunnan 671000, China

Received:2014-08-25 Online:2015-02-15 Published:2015-02-15

摘要/Abstract

摘要：

目的：总结不同术式治疗不同类型尿道下裂的经验和体会，为临床手术方式的选择提供参考。方法：对2009年至2014
年收治的52例施行MAGPI、Onlay、Duckett、Duckett+Onlay、Flip+Flap、尿道成形合并膀胱黏膜成形术6种术式对3种类型尿道
下裂进行回顾性分析。结果：6种术式因针对尿道下裂严重程度各部相同，通过对52例病例进行数据进行统计分析后得到的
治愈率也不相同，其中MAGPI的手术成功率较高，术后尿道狭窄的发生率仅为25.0%且无尿瘘发生，而Flip+Flap术后尿道狭
窄、尿瘘的发生率较高。结论：严格掌握手术适应症，根据患者尿道下裂的类型灵活选用不同术式，可提高手术成功率，降低
手术并发症发生率。

关键词: 尿道下裂, 不同术式, 尿道成形合并膀胱黏膜成形术

Abstract:

Objective: To summarize the experience of using different surgical treatments for hypospadias and provide reference for
the choice of clinical operations. Methods: This paper made a retrospective analysis of 52 cases of hypospadias from 2009 to 2014
treated by MAGPI, Onlay, Duckett, Duckett+Onlay, Flip+Flap and bladder mucosa grafting. Results: The cure rates of six treatments
depended on the severity of hypospadias, according to the statistical analysis of 52 cases. The success rate of MAGPI was highest, with only 25.0% incidence rate of postoperative urethral stricture and no urinary fistula. The incidence rate of postoperative urethral
stricture and urinary fistula was high with Flip+Flap. Conlusion: It is suggested that operation indications should be grasped strictly
and the operative method be determined flexibly according to the type of hypospadias in children, which could improve the success rate of surgery and reduce the incidence of surgical complications.

Key words: hypospadias, different surgical treatments, bladder mucosa grafting

中图分类号:

R691.1

文贵成. 不同术式修复尿道下裂5年诊治体会[J]. J4, 2015, 14(2): 29-32.

Wen Guicheng. The Five-year Experience of Using Different Surgical Treatments for Hypospadias[J]. J4, 2015, 14(2): 29-32.

参考文献

〔1〕Ming-Hsien W，Baskin L S. Endocrine disruptors，genital
development，and hypospadias〔J〕. Journal of Andrology，
2008，29（5）：499-505.
〔2〕Fredell L，Kockum I，Hansson E，et al. Heredity of hypo?
spadias and the significance of low birth weight〔J〕. Urol，
2002，167:1423-1427.
〔3〕Thorup J，McLachlan R，Cortes D，et al. What is new in
cryptorchidism and hypospadias: a critical review on the
testicular dysgenesis hypothesis〔J〕. Pediatr Surg，2010，45:
2074-2086.
〔4〕王忠，任晓敏. 尿道下裂的研究现状〔J〕. 中国男科学杂
志，2005，19（5）:1-3.
〔5〕Duckett J W，Gittes R F，Perlmutter A D，et al. Urethral re?
construction following an unsuccessful one-stage hypospadi?
asrepair〔J〕.WorldJournalofUrology，1987，5（1）：19-24.
〔6〕The International Center for Birth defects. International
Clearing house for Birth Defects Monitoring System〔Z〕.
〔7〕Mac G D，Shankar K R，Rickwood A M. Management of
severe hypospadias usng Glassbergs' modification of the
Duckett repair〔J〕. BJU，2002，89（1）:101-102.
〔8〕Devine C J，Horton C E. Hypospadias repair〔J〕. Urol，1977，
118:188-193.
〔9〕陈宏坤，阎景铁，李敬华. 改良Duckett术式在中重度尿
道下裂治疗中的应用体会〔J〕. 临床小儿外科杂志，2005，
4（1）: 65-66.
〔10〕叶飞，董国勤，蒋跃庆，等. 膀胱黏膜修复尿道下裂及
短期并发症10 年回顾〔J〕. 中国男科学杂志，2008，22
（2）: 3-6.

〔11〕杨体泉. 膀胱粘膜移植法治疗尿道下裂的新进展〔J〕. 中
华小儿外科杂志，2003，24（2）: 168-169.
〔12〕徐珊，唐达星，吴德华，等. 尿道板卷管尿道成形术治
疗小儿尿道下裂〔J〕. 中华男科学杂志，2005，11（5）:
368-370.
〔13〕Paulozzi L J. International trends in rates of hypospadias
and cryptorchidism〔J〕. Environ Health Perspect，1999，
107（4）: 297-302.
〔14〕Baskin L S，Ero A，Ying L. Anatomical studies of hypo?
spadies〔J〕. Uro，1998，160：1108-1115.
〔15〕Xiao N，Wang X C，Diao Y F，et al. Effect of initial fluid
resuscitation on sub sequent treatment in uncontrolled
hemorrhagic shock in rats〔J〕. Shock，2004，21（3）: 276-
280.
〔16〕Mustafa M，Wadie B S，Abo-Enein H. Standard Snod?
grass technique in conjunction with double layer covering
of the neourethra by dorsal dartos flap represent the first
choice of therapy for hypospadias〔J〕. Int Urol Nephrol，
2008，40（3）: 573-576.
〔17〕吴艳乔，王艳萍，朱军，等. 国人尿道下裂的流行病学特
征〔J〕. 中华泌尿外科杂志，1997，12（18）：753．
〔18〕Frank H P，Alex B，Rien J，et al. A high hypospadias rate
in the Netherlands〔J〕. Human Reproduction，2002，17
（4）：1112．