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目的:探讨重建尿道板扩大尿道腔的尿道成形术治疗短段阴茎段尿道重度狭窄或闭锁的效果及安全性。方法:2017年1月至2020年9月河南省人民医院泌尿外科收治短段阴茎段尿道重度狭窄或闭锁患者10例，年龄22～78岁，平均48岁，狭窄或闭锁段长度0.2～0.5 cm，平均0.3 cm。10例患者均采用尿道板重建，游离包皮皮片或狭窄部位邻近带蒂皮瓣扩大尿道腔一期尿道成形术治疗。尿道探子引导下于阴茎腹侧将狭窄段尿道纵行切开，至两端正常尿道黏膜0.5 cm处，充分切除狭窄或闭锁尿道瘢痕组织，适当游离远近端尿道海绵体，将背侧远心端与近心端尿道黏膜直接间断吻合重建尿道板。4例采用游离包皮皮片，6例采用狭窄部位邻近带蒂皮瓣加盖扩大尿道腔一期尿道成形。术后观察随访勃起和性生活情况、排尿通畅情况、尿流率，以及尿道狭窄复发情况。结果:本组10例患者的手术时间为75～100 min，平均85.6 min。术中出血量20～65 ml，平均45.5 ml。术后随访3个月至3年。术后均无痛性勃起及勃起时阴茎下曲，性生活与术前无差异。9例患者术后尿流率较术前明显改善，最大尿流率均>15 ml/s；1例患者术后狭窄复发，行尿道扩张后治愈。结论:尿道板重建，游离皮片或带蒂皮瓣扩大尿道腔一期尿道成形术具有操作简单、创伤小、手术成功率高、并发症少等优点，是修复短段阴茎段尿道重度狭窄或闭锁的有效术式。“,”Objective:To explore the efficacy and safety of urethroplasty combining the reconstruction of urethral plate with the enlargement of urethral cavity in the treatment of short penile urethral atresia or severe stricture.Methods:From January 2017 to September 2020, 10 patients, 22 to 78 years old and the average age 48, with short penile urethral atresia or severe stricture were treated in the Department of Urology, Henan University People’s Hospital, Henan Provincial People’s Hospital. The lengths of the stenotic or atresic segment were 0.2-0.5 cm, with an average length of 0.3 cm. They were all treated with one-stage urethroplasty to reconstructe urethral plate and enlarge urethral cavity with free prepuce skin grafts or pedicled flaps adjacent to the stenosis. By the guidance of urethral dilator, the strictured urethra was incised longitudinally on the ventral side of penis to the distance of 0.5 cm into the normal urethral mucosa at both ends. The stricture or atresic scar tissue of the urethra was removed. The distal and proximal corpus spongiosum were appropriately dissociated, and the urethral mucosa at the both ends of the dorsal side was anastomosed intermittently to reconstruct the urethral plate. Free prepuce skin grafts were used in 4 cases, and pedicled flaps adjacent to the stenosis were used in 6 cases to enlarge the urethral cavity.Results:In this study, the operation time ranged from 75 minutes to 100 minutes, with an average of 85.6 minutes. Intraoperative blood loss ranged from 20 ml to 65 ml, with an average of 45.5 ml. Followed up from 3 months to 3 years postopreatively, all of them did not have painful erection and penile curvature during erection, and felt the same as before in sexual life. Urinary flow rates were significantly improved in 9 cases, and the maximum flow rate was more than 15 ml/s. One recurred patient was cured after urethral dilatation.Conclusions:The one-stage urethroplasty combined the reconstruction of urethral plate with the enlargement of urethral cavity. The urethral plate was reconstructed through urethral resection of narrow segment and the urethral cavity was enlarged with free skin or pedicled flap. This technique has the advantages of a simple and safe operation with a high success rate and a less complication rate. It is an effective procedure to repair short penile urethral atresia or severe stricture.