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介绍33例无尿道下裂的阴茎下弯手术经验。本组不包括远端尿道被覆薄而透明的皮肤者,年龄从6个月至19岁。所有病例在冠状沟后均做环形切开,阴茎皮肤完全脱套至根部,尿道内置一导管做支撑和识别。有10例经游离及切除尿道下及尿道旁使下弯的组织已能完全矫直,如有阴茎体扭转(通常向左,即逆时针方向),在缝皮前可适当矫正。背侧多余阴茎皮肤在相当于12点的位置向近端切开,转移Byar′s皮瓣至腹侧覆盖远端阴茎体。有3例病人尽管切除弯曲组织并延长了尿道,但仍有下弯,则需嵌入真皮以伸直阴茎体。有20例因尿道过短,从阴茎中部离断,其间隙补以移植物,两端均做斜形吻合。14例采用包皮皮肤,4例采用上肢内侧皮肤,2例采用膀胱粘膜,其中4例也须用真皮嵌入阴茎体以伸直之。
Described 33 cases of hypospadias without penile surgery experience. This group does not include the distal urethra is covered with thin transparent skin, from 6 months to 19 years of age. All cases were circumcised after coronary sulcus, the penis skin was completely detached to the root, urethra built a catheter for support and identification. There are 10 cases of free and resection of the urethra and the next to make the next bending of the tissue has been completely straightening, if the penis torsion (usually to the left or counterclockwise direction), before the skin can be properly corrected. The dorsal excess penile skin is incised proximally at a position corresponding to 12 o’clock and the Byar’s flap is transferred to the ventral side to cover the distal penis. In 3 patients, the dermis had to be inserted to straighten the penis, despite the removal of tortuous tissue and prolonged urethra, but with a recurrence. There are 20 cases of urethra is too short, from the middle of the penis off, the gap fill with the graft, both ends of the oblique anastomosis done. 14 cases of foreskin skin, 4 cases of medial upper limb skin, 2 cases of bladder mucosa, of which 4 cases also have to use the dermis embedded in the penis to straighten out.