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目的:探讨带蒂皮瓣尿道外口成形术治疗炎症性尿道外口狭窄的疗效。方法:2009年9月至2013年12月采用带蒂皮瓣法治疗尿道外口狭窄患者32例。所有患者既往均有慢性阴茎头炎病史,曾行尿道外口扩张或尿道外口切开,效果欠佳,最大尿流率(4.3±2.4)ml/s。术中于系带处“∧”形切开正常表皮,向阴茎近端游离表皮获得带蒂皮瓣,纵形切开尿道外口腹侧,充分切除无弹性瘢痕组织,将游离的“∧”形皮瓣嵌入尿道吻合,并重建尿道外口。结果:术后随访6~30个月,全部患者尿道外口狭窄完全解除,排尿通畅,最大尿流率(26.7±4.5)ml/s,无排尿刺激感,无勃起功能障碍。结论:本术式创伤小,并发症少,术后效果理想,是一种有效的、可行的手术方法。但术后阴茎头正常外观存在一定改变,远期疗效有待进一步观察。
Objective: To investigate the curative effect of pedicle flap urethral plasty for the treatment of inflammatory urethral stricture. Methods: From September 2009 to December 2013, 32 patients with urethral stricture were treated with pedicle flap method. All patients had a history of chronic glaucoma, had urethral dilation or urethral incision, the effect is not good, the maximum flow rate (4.3 ± 2.4) ml / s. Surgery at the laparotomy “Λ ” shape cut the normal epidermis, to the proximal penis free epidermis obtained pedicle flap, longitudinal incision urethral ventral ventral, full removal of non-elastic scar tissue, the free “ Λ ”flap embedded in the urethra anastomosis, and reconstruction of the urethral orifice. Results: All patients were completely removed urethral stricture 6 months to 30 months after operation. All the patients had clear urination and maximal uroflow rate (26.7 ± 4.5) ml / s. No urination irritation and no erectile dysfunction. Conclusion: This procedure is less invasive and has fewer complications and satisfactory postoperative results. It is an effective and feasible surgical method. However, there is a certain change in the normal appearance of the glans head after operation, and the long-term efficacy needs further observation.