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从1992年12月至1995年4月,我们应用筋膜皮瓣修补尿道下裂术后尿瘘14例,共17个瘘口。年龄:3.5～14岁。尿瘘修补距上次手术时间13天～2年。原尿道下裂修复方法:包皮瓣10例,皮管皮条法3例。膀胱粘膜再造尿道1例。尿瘘口位置:2处位于冠状沟,5处位于阴茎体,10处位于阴茎根部。有2个瘘口和3个瘘口各1例。手术方法:检查前尿道位置,观察有无狭窄,评价尿道周围组织质量,确定瘘口位置及数目。顺着尿瘘口边缘切开,去除影响瘘口内翻复位的瘢痕组织,连续或间断缝合皮下或粘膜下组织,有条件可再缝合一层尿道周围组织,缝合后可能出现一大瘘口,根据瘘口的大小设计一个带有较大筋膜而与瘘口等大之皮瓣修补瘘口,一般筋膜应比皮瓣大0.5 cm 以上,筋膜四周缝合固定于瘘口周围白膜上,然后将四周阴茎皮肤拉扰与皮瓣缝合关闭创口。根据情况行耻骨上膀胱造瘘或留置导尿管。治疗结果:13例Ⅰ期愈合,排尿通畅无渗漏。1例术后前尿道梗阻,尿外渗致阴囊血肿,经
From December 1992 to April 1995, we applied fascia flap to repair 14 cases of urinary fistula after hypospadias surgery, a total of 17 fistula. Age: 3.5 ~ 14 years old. Urinary fistula repair from the last operation time of 13 days to 2 years. The original hypospadias repair methods: 10 cases of skin flap, leather tube law in 3 cases. Bladder mucosa reconstruction urethra in 1 case. Location of urinary fistulas: 2 in the coronary sulcus, 5 in the penis, 10 in the penis. There are 2 fistula and 3 fistula in 1 case. Surgical methods: Check the location of the anterior urethra, observe the presence or absence of stenosis, evaluate the quality of tissue around the urethra, determine the location and number of fistula. Along the edge of the fistula incision to remove the impact of fistula varicose scar tissue, continuous or intermittent subcutaneous or submucosal suture, the condition can be re-sutured around the urethra tissue, suture may occur after a large fistula, according to the fistula The size of the mouth design with a large fascia and fistula and other large flap repair fistula, the general fascia should be more than 0.5 cm larger than the flap, the fascia around the fistula suture fixed around the white membrane, and then Surround the penis skin to disturb and flap suture to close the wound. According to the situation, suprapubic bladder fistula or indwelling catheter. Treatment results: 13 cases of first-degree healing, voiding patency no leakage. One case had anterior urethral obstruction and a scrotal hematoma caused by extravasation