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目的:通过分析总结尿道下裂术后残留阴茎下弯的病例资料及治疗经验,探讨矫正阴茎下弯在尿道下裂治疗中的重要性。方法:回顾分析本院泌尿外科2005~2015年收治的尿道下裂术后残留阴茎下弯(>30°)的108例患者资料。年龄2岁5个月~16岁4个月,平均8岁2个月,平均住院次数1.81次,平均住院时间13.2d。治疗方法:Ⅰ期下弯矫正尿道成形术或分期手术(Ⅰ期下弯矫正尿道造瘘,Ⅱ期卷管成形尿道)。结果:Ⅰ期手术29例,分期手术79例,总体成功率分别为65.5%(19/29)、68.3%(54/79)。10例残留较轻下弯的患者保留了尿道板。平均随访4年6个月,无下弯复发病例。结论:医生应认识阴茎下弯矫正在首次手术中的重要性,一旦矫正不彻底,至少需2~3次手术再次修复,加大再次手术难度,增加患儿住院次数,影响患儿心理发育。
OBJECTIVE: To investigate the importance of correction of penile curvature in the treatment of hypospadias by analyzing the case data and treatment experience of residual penile curvature after hypospadias surgery. Methods: The data of 108 patients with residual penile curvature (> 30 °) after hypospadias surgery in our hospital from 2005 to 2015 were retrospectively analyzed. Age 2 years 5 months to 16 years 4 months, mean 8 years 2 months, the average number of hospitalizations 1.81 times, the average length of stay 13.2d. Treatment methods: Phase Ⅰ correction of hypospadias or staging surgery (Ⅰ phase correction of urethral ostomy, Ⅱ phase tube wound urethra). Results: Twenty-nine cases were stage Ⅰ operation and 79 cases were operated on stage. The overall success rates were 65.5% (19/29) and 68.3% (54/79) respectively. Ten patients with residual lower bends retained the urethral plate. The average follow-up of 4 years and 6 months, no recurrence of recurrence. Conclusion: The doctor should recognize the importance of correction of penile curvature in the first operation. Once the correction is not complete, at least 2 or 3 times of surgical resection is needed to increase the difficulty of reoperation and increase the number of hospitalizations and the psychological development of children.