作者感谢约翰霍普金斯大学的手术室工作人员，并在约翰霍普金斯儿童医院的儿科部媒体关系。

简介： 生殖器疾病是经常遇到的初级保健医生的办公室。尿道外口狭窄，尿道口（鼻道）的异常缩小包皮环切术后发生在9％-10％的男性是一种常见的并发症。这种疾病的特点是向上偏转，难以对目标流尿，排尿困难，尿急，频繁，长期排尿。如果不及时治疗，这可能会导致尿路感染和肾脏问题。手术meatotomy / meatoplasty有疗效。 治疗/诊断程序： 常规的尿液分析将排除尿路感染或糖尿病，尿频的潜在原因。 详细询问病史和体检，包括排尿的观察，确诊。 门诊手术/ meatoplasty有疗效。过程5-10分钟麻醉下进行。 术中准备包括手术放大镜放大，蚊子止血，细尖塑料显微剪刀，Castroviejo持针器，和7-0薇乔缝线; <ol><li>孩子是摆在仰卧位。 </li><li>最小的皮肤准备和悬垂性的生殖器。无需预防性使用抗生素。 <ul><li>使用优碘聚维酮碘溶液擦洗生殖器区域，并允许保持大约3分钟前初始切口。 </li><li>阴茎应该用无菌毛巾披。 </li></ul></li><li>右手开站到左侧的耐心和良好的润滑蚊子止血颚头/腹侧尿道口深度约2-3毫米，然后将推出。腹侧组织关闭的止血，然后粉碎。总阻断时间为60秒。 </li><li>粉碎腹侧组织阴刻大幅显微剪刀（图1）和内在的尿道粘膜和glanular组织reapproximated在中断方式使用7-0薇乔缝线（Castroviejo持针器图2）。 </li></ol>恢复时间是最小的，和孩子送到家庭与泰诺不适需要。凡士林是适用于伤口3-4x/day。

<ol>
	<li>Van Howe, R. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Incidence+of+meatal+stenosis+following+neonatal+circumcision+in+a+primary+care+setting.">Incidence of meatal stenosis following neonatal circumcision in a primary care setting.</a> Clin Pediatr (Phila). 45 (1), 49-54 (2006).</li><li>Litvak, A. S., Morris, J. A., McRoberts, J. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Normal+size+of+the+urethral+meatus+in+boys.">Normal size of the urethral meatus in boys.</a> J Uro. 115 (6), 736-737 (1976).</li><li>Brown, M. R., Cartwright, P. C., Snow, B. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Common+office+problems+in+pediatric+urology+and+gynecology.">Common office problems in pediatric urology and gynecology.</a> Pediatr Clin North Am. 44 (5), 1091-1115 (1997).</li><li>Smith, C., Smith, D. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Office+pediatric+urologic+procedures+from+a+parental+perspective.">Office pediatric urologic procedures from a parental perspective.</a> Urology. 55 (2), 272-276 (2000).</li><li>Frank, J. D., Pocock, R. D., Stower, M. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Urethral+strictures+in+childhood.">Urethral strictures in childhood.</a> Br J Urol. 62 (6), 590-592 (1988).</li><li>Persad, R., Sharma, S., McTavish, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+presentation+and+pathophysiology+of+meatal+stenosis+following+circumcision.">Clinical presentation and pathophysiology of meatal stenosis following circumcision.</a> Br J Urol. 75 (1), 91-93 (1995).</li><li>Stenram, A., Malmfors, G., Okmian, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Circumcision+for+phimosis:+a+follow-up+study.">Circumcision for phimosis: a follow-up study.</a> Scand J Urol Nephrol. 20 (2), 89-92 (1986).</li><li>Hinman, F., Baskin, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Chapter+155.">Chapter 155.</a> Hinman s Atlas of Pediatric Urologic Surgery. , 773-775 (2008).</li><li>Belman, A. B., King, L. R., Kramer, S. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Clinical Pediatric Urology. , 214-215 (2002).</li><li>Wein, A. J., Kavoussi, L. R., Novick, A. C., Partin, A. W., Peters, C. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Campbell-Walsh Urology. , 1044-1045 (2007).</li></ol>

结果： 症状性尿道狭窄是令人沮丧的儿童和家庭。如果不及时治疗，有一个潜在的慢性膀胱排空不全，尿路感染和随后的肾功能损害的偶然发展。 重建meatoplasty治疗，可以做一个简短的麻醉下。 结论： 尿道外口狭窄是常见的并发症的割礼。一个彻底的历史和物理，就会发现尿道外口狭窄的诊断。手术治疗是根治性?...

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surgical management of meatal stenosis with meatoplasty

包皮环切术后尿道狭窄是一种常见的的泌尿系统并发症。儿童目前他们的初级保健医生偏离尿流的投诉，难以目的，尿痛，尿频。临床检查发现一个精确的鼻道，如果孩子要小便，他通常也会有一个向上的，瘦的，偶尔有力的膀胱排空不全尿流。管理的主体是meatoplasty（重建远端尿道/鼻道）。这种教育视频将证明这是如何进行的。

Watch this Scientific Journal Video about Surgical Management of Meatal Stenosis with Meatoplasty at JoVE.com

Surgical Management of Meatal Stenosis with Meatoplasty

Meatoplasty，尿道外口狭窄的手术管理。

管理与Meatoplasty尿道外口狭窄的外科治疗

Meatal stenosis is a common urologic complication after circumcision.  Children present to their primary care physicians with complaints of deviated ...

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52.2K 次观看.  Johns Hopkins School of Medicine. Meatoplasty，尿道外口狭窄的手术管理。