Surgical treatment of urethral distraction defect associated with pelvic fracture: A nationwide survey in Japan
Surgical treatment of urethral distraction defect associated with pelvic fracture: A nationwide survey in Japan
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DOI：
10.1111/j.1442-2042.2008.02064.x
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发表时间：
2008-07-01
影响因子：
2.6
通讯作者：
Okada, Hiroshi
中科院分区：
文献类型：
--
作者：
Kitahara, Satoshi;Sato, Ryo;Okada, Hiroshi
目的：调查的实践模式，在手术治疗尿道牵引缺损伴骨盆骨折（PFUDD），并分析在Japanese.Methods的治疗结果：一份调查问卷，对PFUDD手术治疗的3307日本咨询泌尿科医生发送。结果：调查对象共1290人（39%）。在过去5年中，919名泌尿科医生（71%）接受手术治疗的PFUDD患者总数为0，283名（22%）为1 - 2，83名（7%）泌尿科医生为3 - 10。205例患者（23%）在2周内进行了PFUDD重新对准，607例患者（69%）在2-6个月后进行了PFUDD重新对准，72例患者（8%）在6个月以上进行了PFUDD重新对准。泌尿外科医生对361例（61%）患者进行了内窥镜手术（ES），108例（18%）采用开放吻合术（OA），101例（17%）采用拉通手术（PT）。根据术者的印象，ES的成功率为65%，PT为79%，OA为69%。ES、PT和OA的再手术（RO）率分别为43%、25%和26%（ES vs PT或OA; P < 0.05）。71%的ES、77%的PT和38%的OA患者需要术后重复尿道扩张（PORUD）（OA vs ES或PT; P < 0.05）。延迟内镜重新对准是首选的治疗方案。三种手术治疗的成功率没有差异。在PORUD和RO方面，OA上级ES和PT。
Objective: To survey practice patterns in surgical treatment for urethral distraction defect associated with pelvic fracture (PFUDD) and to analyze outcomes of the treatment in Japan.Methods: A questionnaire on surgical treatment for PFUDD to 3307 Japanese consultant urologists was sent. Responses were collected and statistically analyzed.Results: The number of respondents was 1290 (39%). Patients surgically treated for PFUDD in the previous 5 years totaled 0 for 919 urologists (71%), one to two for 283 (22%), and three to ten for 83 (7%) urologists. Realignment for PFUDD was carried out within 2 weeks in 205 patients (23%), after 2-6 months in 607 (69%) patients, and after more than 6 months in 72 (8%) patients. Urologists operated on 361 (61%) patients endoscopically (ES), 108 (18%) by open anastomosis (OA) and 101 (17%) by pull-through operation (PT). According to the operator's impression, success rates were 65% for ES, 79% for PT and 69% for OA. Re-operation (RO) rates were 43%, 25% and 26% for ES, PT, and OA, respectively, (ES vs PT or OA; P < 0.05). Postoperative repeated urethral dilatation (PORUD) was required in 71% of ES, 77% of PT and 38% of OA cases (OA vs ES or PT; P < 0.05).Conclusions: PFUDD represents a rare disorder for Japanese urologists. Deferred endoscopic realignment is the preferred treatment option. Success rates were not different among three surgical treatments. OA was superior to ES and PT in terms of PORUD and RO.