尿道下裂尿道成形术后尿瘘的修复

摘要

总结尿道下裂尿道成形术后尿瘘117例.一次修补成功率62.4%,其中大瘘为52.4%,小瘘70%.大尿瘘修补用Duplay、Thiersch、Duckett、Denis-Browne、Mathieu等尿道成形术.小瘘用结扎法、简单切开缝合法、Y-V皮瓣覆盖尿瘘修补法.对各种方法的应用指征、手术效果、术前术后的处理及影响手术的因素作了探讨.%A retrospective analysis of urethral fistula in recent 6 years was made in order to choose a proper procedure for repair.There were 117 cases who received 155 urethral fistula repairs which were performed at least 6 months after the previous operation.The method of repair was chosen mainly on the size of the urethral fistula,so it was divided into two groups;small fistula and larger one.Seventy-three cases were cured by one operation(successful rate:62.4%).Large fistula required urethroplasty in cluding.Duplay's(23),Thiersch's(19),Duckett's(3),Denis-Browne's(11),Mathieu's(3),A them,Duplay's and Thiersch's were the common methods.The result of Thiersch's was better than Duplay's result(P＜0.05).Small fistulas were repaired by:1.ligation of the fistula (18),2.suturing of fistula and skin(55),3.suturing of the fistula and closing of skin by Y-V flap(23)which would cover the suture line of fistula with better results.Suture material and skillfulness of the operator were also the important factors.