從民國七十七年一月至七十八年六月，馬偕紀念醫院泌尿外科在14位尿道下裂或尿道瘻管之病人，施行尿道成形術時，使用短式尿道撐管(short urethral stent)引流尿道。手術後，病人須自行排尿。撐管留置時間平均為13天。由於短式尿道撐管之留置，使得排尿時尿道內之壓力不致昇高太多，因而減少尿液從傷口滲漏之機率。間歇性自行排尿，可以清洗尿道，減少感染。由於兼具以上兩項優點，可能因此提高成功率。本系列個案，手術後追蹤均超過半年，未發生瘻管之併發症，其成功率為百分之百。茲將此法詳細介紹並討論之。(J Urol R.O.C., 1: 117-121, 1990)

Fistula formation is the most common and undesirable complication of urethroplasty in hypospadias. The incidence is 4-30%. Although gentle tissue handling, meticulous hemostasis, accurate suture technique, avoidance of overlapping suture lines and elimination of dead space are well recognized as measures in prevention of fistula formation , however, there remains some controversies in the modes of postoperative urine diversion, therefore, application of a most ideal form of diversion may play an important role in improving success rate. Bladder spasm and wound infection are not infrequently seen in conventional methods of diversion---the indwelling Foley catheter, suprapubic cystostomy, perineal urethrostomy and long urethral stent. A short urethral stent, on the other hand, is free form these drawbacks. The pressure in the neourehtra during voiding is low enough to prevent leakage in the wound. The intraurethral secretion and exudation are periodically cleansed by the voiding stream. Thus, theoretically, the incidence of formation of urethrocutaneous fistula is markedly reduced. We herein report 14 cases of hypospadias repair with usage of short urethral stent. Among these patients, 3 were fresh cases that underwent one-stage repair with release of chordee and flip-flap urethroplasty. Eleven patients had previous surgery-release of chordee and formation of scrotal tube flap in 8 cases and failed urethroplasty with fistula formation in 3 cases. At operation, a short silastic tube is inserted into the distal urethra with the proximal end extending to 2 cm above the neourethra. The distal end of the tube is anchored to the glans penis with a transfixing suture of 4-0 Nylon. The duration of postoperative stenting was 3 to 26 days with an average of 13 days. Although there was one case of external skin flap necrosis that later required skin grafting and another case of wound infection that was successfully managed with wet dressing, all 14 cases were free from complication of fistula formation. From the limited available experience, application of short urethral stent showed beter result in urethroplasty. The role of the short urethral stent in reducing fistula formation will be further verified if more cases were collected.