Advances in urethral stricture management.
Advances in urethral stricture management.
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DOI：
10.12688/f1000research.9741.1
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发表时间：
2016-01-01
期刊：
影响因子：
--
通讯作者：
Santucci, Richard A
中科院分区：
文献类型：
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作者：
Gallegos, Maxx A;Santucci, Richard A
尿道狭窄是指尿道管腔狭窄。这些情况极大地影响了患者的健康和生活质量。尿道狭窄/狭窄的处理是复杂的，需要仔细评估。尿道狭窄的治疗方案成功率各不相同。尿道扩张术和内尿道切开术是最常用的手术，但长期成功率最低（0-9%）。尿道成形术成功率高得多（85-90%），被认为是黄金标准的治疗方法。最常见的输尿管成形术是切除、一期吻合术和移植物尿道成形术。吻合口尿道成形术和移植物尿道成形术具有相似的长期成功率，尽管长期数据尚未证实相同的疗效。吻合口尿道成形术可能有较高的性功能障碍发生率。后尿道狭窄通常是由以前的泌尿外科手术引起的。内镜下采用放射状切口治疗。使用丝裂霉素C可减少复发率。一个令人兴奋的研究领域是组织工程和疤痕调节，以增加狭窄的治疗。这些方法包括使用脱细胞基质或组织工程颊粘膜来生产用于尿道成形术的移植材料。其他实验策略旨在完全防止疤痕形成。
Urethral stricture/stenosis is a narrowing of the urethral lumen. These conditions greatly impact the health and quality of life of patients. Management of urethral strictures/stenosis is complex and requires careful evaluation. The treatment options for urethral stricture vary in their success rates. Urethral dilation and internal urethrotomy are the most commonly performed procedures but carry the lowest chance for long-term success (0-9%). Urethroplasty has a much higher chance of success (85-90%) and is considered the gold-standard treatment. The most common urethroplasty techniques are excision and primary anastomosis and graft onlay urethroplasty. Anastomotic urethroplasty and graft urethroplasty have similar long-term success rates, although long-term data have yet to confirm equal efficacy. Anastomotic urethroplasty may have higher rates of sexual dysfunction. Posterior urethral stenosis is typically caused by previous urologic surgery. It is treated endoscopically with radial incisions. The use of mitomycin C may decrease recurrence. An exciting area of research is tissue engineering and scar modulation to augment stricture treatment. These include the use of acellular matrices or tissue-engineered buccal mucosa to produce grafting material for urethroplasty. Other experimental strategies aim to prevent scar formation altogether.