中文摘要：

目的：探讨横裁包皮带蒂岛状皮瓣尿道成形术（Duckett术）一期治疗尿道下裂的临床效果。方法：回顾性研究我科2003年～2007年采用Duckett术式一期修复尿道下裂患者20例，年龄2～22岁，平均11．3岁，其中阴茎体型3例，阴茎阴囊型17例；另外收集同期行膀胱粘膜代尿道术尿道下裂30例，年龄7—34岁，平均16．1岁，其中阴茎体型10例，阴茎阴囊型16例，会阴型2例，阴囊型2例。膀胱粘膜术全部行膀胱造瘘及留鼍尿道支架管，Duckett术仅留置尿道支架管。结果：Duckett术：1次手术成功17例（85％），术后尿瘘2例（10％），尿道狭窄1例（5％），2例尿瘘术后6个月修补成功，人均手术次数为1．1次；膀胱粘膜代尿道术：手术均分二期完成，手术成功26例（86．7％），术后尿瘘3例（10％），尿道狭窄1例（3．3％），再次手术修补瘘口治愈，人均手术次数为2．1次。2例尿道狭窄行尿道扩张后基本痊愈。结论：Duckett术一期修复尿道下裂效果良好，手术成功率与其他术式相近、术后并发症低，与膀胱粘膜尿道成形术相比，术后阴茎外观更满意，主要优点是一次完成手术。

英文摘要：

Objective： To study the clinical effect of Duckett＇s procedure of one-stage urethroplasty with the transverse preputial island flap in the treatment of hypospadias. Methods ： We retrospectively studied 20 cases of hypospadias treated by Duckett＇s procedure of one-stage urethroplasty with the transverse preputial island flap （Group A） from 2003 to 2007. The patients ranged in age from 2 to 22 years （mean 11.3 years）. Another 30 hypospadias patients aged 7 to 34 （mean 16. 1 ） years underwent urethroplasty with mucous membrane of the bladder （Group B） in the same period. Of the 50 cases, 13 were the penile type, 33 the penoscrotal type, 2 the scrotal type, and 2 the perineal type. Catheters were indwelled in Group A, but both cystostomy and catheter indwelling were used in Group B. Results： For Duckett＇s procedure, surgery - succeeded in 17 cases （85%）, urethrastenosis developed in 1 （5%） and urinary fistula in 2 （ 10% ） , which were successfully repaired 6 months after the opcration. The mean operation frequency was 1. i per patient. In Group B, the operation was accomplished in 2 stages and succeeded in 26 cases （ 86.7% ）, with postoperative development of urinary fistula in 3 （ 10% ） and urethrastenosis in 1 （3.3%）. The mean operation frequency was 2.1 per patient. The 2 cases of postoperative urethrastenosis were both cured by urethral sounding. Conclusion： Duckett＇s procedure of one-stage urethroplasty with the transverse preputial island flap is effective in hypospadias repair, with a success rate close to that of other types of operations and a low rate of postoperative complications. Compared with the use of mucous membrane of the bladder, it has the advantages of one-move accomplishment and gives a better penile appearance.