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目的对膀胱粘膜尿道成形术治疗复杂性尿道下裂的适应证及手术方法进行讨论,以重新认识其应用价值。方法总结2002~2004年经多次手术失败的复杂性尿道下裂7例,平均尿道缺损5.7cm,采用改进后的膀胱粘膜尿道成形术I期尿道成形的资料。结果术后均获得较为满意的疗效,阴茎伸直满意,外形好,尿线粗,开口近似正常位置。2例术后尿瘘,6个月后再次修补获成功,手术一次成功率71.4%。结论对多次手术失败、阴茎疤痕严重、局部取材困难、尿道缺损过长的复杂尿道下裂的病例,采用膀胱粘膜尿道成形术I期尿道成形仍是目前合理、有效的手术方法。
Objective To discuss the indications and surgical methods of bladder mucosal urethroplasty in the treatment of complicated hypospadias, so as to re-understand its application value. Methods From 2002 to 2004, 7 patients with complex hypospadias who underwent multiple surgeries failed with an average urethral defect of 5.7cm. The data of stage I urethroplasty with bladder mucosal urethroplasty were retrospectively reviewed. Results All patients were satisfied with the curative effect. The penis was straight and satisfied with good appearance, thick urine and approximate normal position. Two cases of postoperative urinary fistula, 6 months after the repair again successful, a successful rate of 71.4% surgery. Conclusion For many cases of failed surgery, severe penile scarring, difficult local drawing, and complicated hypospadias with long urethral defect, it is still a reasonable and effective surgical method to use stage I urethroplasty of bladder mucosa and urethroplasty.