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患者,男,32岁。因“膀胱外翻、完全性尿道上裂”于25年前及15年前曾两次在外院行膀胱修复术,当时未作尿道成形。术后腹壁切口下端及尿道口溢尿不止,但未影响体格发育,尚能从事一般农业劳动。近一年来出现下腹部疼痛来我院就诊。检查;发育正常。脐缺如。下腹部可见一10cm长手术瘢痕,其下方有一0.3cm瘘口,漏尿不止。瘘口下方可见一裂隙状尿道口与阴茎背侧分裂之尿道粘膜相连,有尿液溢出。阴茎长约2.5cm,扁片状,略背屈。阴毛稀疏,会阴皮肤呈湿疹样变。两睾丸大小正常。手术瘢痕区有压痛,并可触及一手拳大小硬块。耻骨联合缺如。骨盆区平片:膀胱区有一阳性结石影,约8.6×7 cm(图略)。尿常规:脓细胞(+++),红细胞少许,BUN 8 mg%,co_2cp54
Patient, male, 32 years old. Because of “bladder eversion, complete cleft lip,” 25 years ago and 15 years ago twice outside the line of bladder repair, was not for urethroplasty. Postoperative abdominal incision and urethral urethral urethral orifice more than, but did not affect physical development, still able to engage in general agricultural work. Nearly a year to appear in our hospital lower abdominal pain. Check; normal development. Absent navel. The lower abdomen can be seen a 10cm long surgical scar, there is a 0.3cm fistula below, leakage of urine more than. A fissure-like urethral opening is visible below the fistula and is connected to the urethral mucosa that splits the dorsal penis. There is urine spilling. Penis length of about 2.5cm, flat, slightly dorsiflexion. Sparse pubic hair, perineal skin was eczema-like change. Two testicular size normal. Surgical scar area tenderness, and can reach the size of a hand punch lumps. Pubic symphysis absent. Pelvic plain film: There is a positive shadow of the bladder area, about 8.6 × 7 cm (Figure omitted). Urine routine: pus (+++), a little red blood cells, BUN 8 mg%, co_2cp54