Buccal mucosal urethroplasty for balanitis xerotica obliterans related urethral strictures: The outcome of 1 and 2-stage techniques
Buccal mucosal urethroplasty for balanitis xerotica obliterans related urethral strictures: The outcome of 1 and 2-stage techniques
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DOI：
10.1097/01.ju.0000149740.02408.19
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发表时间：
2005-02-01
影响因子：
6.6
通讯作者：
Kumar, A
中科院分区：
文献类型：
--
作者：
Dubey, D;Sehgal, A;Kumar, A
目的：干燥闭塞性龟头炎 (BXO) 相关的狭窄很复杂，通常通过两阶段尿道成形术治疗。我们介绍了针对此类狭窄的 I 期背侧嵌体和 2 期颊粘膜尿道成形术的结果。材料和方法：2000 年 1 月至 2004 年 4 月期间，39 名患者接受了颊粘膜尿道成形术治疗 BXO 相关的前尿道狭窄。 25 名具有可挽救尿道板的患者（第 1 组）接受了 1 阶段背侧覆盖尿道成形术（使用美容切口）进行治疗。这14名患者的尿道板有严重疤痕。局灶性致密节段或活动性感染（第 2 组）接受 2 阶段尿道成形术。对两组的美观、狭窄复发和并发症等结果进行评估。结果：平均随访 32.5 个月（范围 3 至 D52），第 1 组中有 3 名患者（12%）出现复发性狭窄，其中 2 名和 1 名患者接受了光学尿道切开术和尿道扩张术治疗。分别。所有患者均具有正常的裂隙状鼻道，且无一例存在腱索或勃起功能障碍。 4 名第 2 组患者 (28.6%) 需要造口修复，其中 2 名患者出现龟头裂。第一阶段尿道成形术后变窄。 2 期后，3 名患者出现复发性狭窄。其中 2 例接受光学尿道切开术治疗，1 例接受重复尿道成形术。结论：在 BXO 相关狭窄中，采用可行的尿道板 L 阶段背侧嵌体颊粘膜尿道成形术提供了良好的中期结果。所描述的美容切口提供了正常的、宽口径的、狭缝状的龟头。两阶段手术提供了令人满意的结果，但它们与较高的翻修率相关。
Purpose: Balanitis xerotica obliterans (BXO) related strictures are complex and generally managed by 2-staged urethroplasty. We present our results with I-stage dorsal onlay and 2-stage buccal mucosal urethroplasty for such strictures.Materials and Methods: Between January 2000 and April 2004,39 patients, underwent buceal mucosal urethroplasty for BXO related anterior urethral strictures. The 25 patients with a salvageable urethral plate (group 1) were treated with 1-stage dorsal onlay urethroplasty- using a cosmetic incision. The 14 patients with a severely scarred urethral plate. focally dense segments or active infection (group 2) underwent 2-stage urethroplasty. Outcomes in terms of cosmetic appearance, stricture recurrence and complications in the 2 groups were assessed.Results: At a mean followup of 32.5 months (range 3 to D52) 3 patients, (12%) in group 1 had recurrent stricture, of which 2 and 1 were treated with optical urethrotomy and urethral dilation. respectively. All patients had a normal slit-like meatus and none had chordee or erectile., an dysfunction. Four group 2 patients (28.6%) required stomal revision and 2 had glans cleft. narrowing after stage 1 urethroplasty. Following stage 2, 3 patients had recurrent stricture. of whom 2 were treated with optical urethrotomy and 1 underwent repeat urethroplasty.Conclusions: In BXO related strictures with a viable urethral plate-l-stage dorsal onlay buccal mucosal urethroplasty provides excellent intermediate term results. The cosmetic incision described provides a normal, wide caliber, slit-like glans. Two-stage procedures provide satisfactory outcomes but they are associated with a higher revision rate.