毛开熠,马 洪,毛羽晨,张中严,周光旭

手术治疗是尿道下裂目前唯一有效的治疗方法。然而，尿道皮肤瘘是最常见的并发症，严重影响患者的生活质量。患儿的年龄、尿道缺损长度、阴茎下弯程度以及术者的经验等因素都是重要的风险因素。目前，尿道皮肤瘘仍然是尿道下裂术后面临的重大挑战之一。因此，本文总结并探讨尿道下裂术后尿道皮肤瘘的现状及相关因素，旨在为临床治疗提供更为坚实的理论基础和实践指导参考。

尿道下裂；术后并发症；尿道皮肤瘘；危险因素

[1] Yu X,Nassar N,Mastroiacovo P,et al.Hypospadias Prevalence and Trends in International Birth Defect Surveillance Systems, 1980-2010.Eur Urol.2019;76(4):482-490. [2] Li Y,Mao M,Dai L,et al.Time trends and geographic variations in the prevalence of hypospadias in China.Birth Defects Research. 2012;94(1):36-41. [3] Baskin L.What Is Hypospadias?Clin Pediatr.2017;56(5):409-418. [4] Phillips L,Dennermalm N,Örtqvist L,et al.A qualitative content analysis of the experience of living with hypospadias:varying impact on identity and interpersonal relationships.Frontiers in Pediatrics.2024;12:1459561. [5] Örtqvist L,Fossum M,Andersson M,et al.Sexuality and fertility in men with hypospadias;improved outcome.Andrology.2017;5(2):286-293. [6] Huang Y,Xie H,Lv Y,et al.One-stage repair of proximal hypospadias with severe chordee by in situ tubularization of the transverse preputial island flap.Journal of Pediatric Urology.2017;13(3):296-299 [7] Schneuer FJ,Holland AJA,Pereira G,Bower C,Nassar N.Prevalence,repairs and complications of hypospadias:an Australian population-based study.Arch Dis Child.2015;100(11):1038-1043. [8] Long CJ,Chu DI,Tenney RW,et al.Intermediate-Term Followup of Proximal Hypospadias Repair Reveals High Complication Rate.Journal of Urology.2017;197(3 Part 2):852-858. [9] 韦科越,王从军,陈超.220例尿道下裂诊治体会.国际泌尿系统杂志.2018;38(1):106-109. [10] Cimador M,Vallasciani S,Manzoni G,Rigamonti W,De Grazia E,Castagnetti M.Failed hypospadias in paediatric patients.Nat Rev Urol.2013;10(11):657-666 [11] Bush NC,Villanueva C,Snodgrass W.Glans size is an independent risk factor for urethroplasty complications after hypospadias repair.Journal of Pediatric Urology.2015;11(6):355.e1-355.e5 [12] Aldaqadossi HA,Eladawy M,Shaker H,Kotb Y,Azazy S.Tunica vaginalis graft for recurrent urethrocutaneous fistula repair after hypospadias surgery.Int J Urol.2020;27(9):726-730 [13] Department of Urology,Pusan National University Yangsan Hospital,Yangsan,Korea,Abdullaev Z,Department of Pediatric Urology, National Children’s Medical Center,Tashkent,Uzbekistan,et al.Risk factors for fistula recurrence after urethrocutaneous fistulectomy in children with hypospadias.TürkÜrol Derg/turk J Urol.2021;47(3):237-241 [14] He Z,Yang B,Yunman Tang,Mao Y.Analysis of factors associated with postoperative complications after primary hypospadias repair:a retrospective study.Transl Androl Urol.2022;11(11):1577-1585. [15] 唐英,陈瑶瑶,刘雁圆,陈毅夫.小儿尿道下裂术后尿道瘘影响因素分析及护理对策.国际护理学杂志.2021;40(11):1943-1946. [16] 窦茂梅,吴文红,杨燕华,张容,汲秀珍.精细化护理干预在预防行尿道下裂术患者术后尿道狭窄中的应用研究.实用临床医药杂志.2018;22(12):94-97.

点击下载PDF