目的　评价经耻骨会阴联合途径治疗男童复杂性后尿道狭窄或闭锁的临床疗效。方法　 15例复杂性后尿道狭窄或闭锁的男童均行经耻骨会阴联合途径后尿道端端吻合术 ,其中 3例合并尿道直肠瘘。结果　 15例均一次手术成功 ,术后均能自主排尿 ,排尿通畅。10例术后最大尿流率(MFR)平均 12 .5ml/s,3例术后有尿失禁现象 ,其中 2例 6个月后尿失禁现象明显改善。 11例随访 6～ 36个月 ,排尿仍通畅 ,无需尿扩 ,步态平稳。结论　该术式适于尿道狭窄段较长或伴有尿道直肠瘘、假道等复杂性后尿道狭窄 ,尤其是以往经会阴途径后尿道修复手术失败者 Objective To evaluate the clinical efficacy of the pubic perineum combined approach in the treatment of post-urethral stenosis or atresia in boys. Methods Fifteen cases of complicate posterior urethral stricture or atresia were treated by posterior urethral anastomosis through the pubic perineal junction. Among them, 3 cases had urethral rectal fistula. Results All the 15 cases were successful in one operation. After operation, they could both spontaneously urinate and clear urination. The mean postoperative maximal flow rate (MFR) was 12.5 ml / s in 10 cases, and 3 cases had urinary incontinence after operation. Among them, urinary incontinence was significantly improved in 2 cases after 6 months. Eleven patients were followed up for 6 to 36 months. The urination was still smooth, no urination was required, and the gait was stable. Conclusion The procedure is suitable for urethral stricture longer or associated with urethral rectal fistula, prosthesis and other complications of urethral stricture, especially after the previous perineal urethral repair surgery failed