Porcine small intestinal submucosa graft for repair of anterior urethral strictures
Porcine small intestinal submucosa graft for repair of anterior urethral strictures
复制标题
DOI：
10.1016/j.eururo.2007.01.099
复制
发表时间：
2007-06-01
期刊：
影响因子：
23.4
通讯作者：
Student, Vladimir
中科院分区：
文献类型：
--
作者：
Fiala, Richard;Vidlar, Ales;Student, Vladimir
目的：评价猪小肠黏膜下层(SIS)在治疗炎症性、医源性、创伤后和特发性球、阴茎尿路狭窄中的应用。方法：对50例45~73岁前尿路狭窄患者采用猪SIS胶原基基质进行尿路成形术。球部狭窄10例，球部狭窄31例，阴茎远端狭窄9例。所有患者均接受了四层SIS贴片植入术。术前术后均进行排尿史、逆行和顺行尿路造影术及膀胱镜检查。结果：平均随访31.2个月(范围24-36个月)，40例(80%)患者的临床、放射学和美容表现良好。狭窄发生在10个球部中的1个、31个球囊中的5个和9个阴茎狭窄中的4个。这些均发生在术后前6个月。所有复发的患者都需要进一步治疗，但到目前为止还没有观察到额外的复发。无瘘、伤口感染、尿路感染和排斥反应等并发症发生。结论：惰性猪SIS基质的使用似乎有利于球部和球囊扩张狭窄的患者。中期结果可与皮瓣和粘膜移植相媲美。(C)2007年欧洲泌尿外科协会。爱思唯尔出版，版权所有。
Objectives: We evaluated porcine small intestinal submucosa (SIS) used in the treatment of inflammatory, iatrogenic, posttraumatic, and idiopathic strictures of bulbar and penile urethra. Midterm maintenance of urethral patency was assessed.Methods: Fifty patients aged 45-73 yr with anterior urethral stricture underwent urethroplasty using a porcine SIS collagen-based matrix for urethral reconstruction. Stricture was localized in the bulbar urethra in 10 patients, the bulbopenile area in 31 cases, and in the distal penile urethra in nine patients. All patients received a four-layered SIS patch graft in an onlay fashion. A voiding history, retrograde and antegrade urethrography, and cystoscopy were performed preoperatively and postoperatively. Failure was defined as stricture confirmed on urethrogram.Results: After a mean follow-up of 31.2 mo (range: 24-36 mo), the clinical, radiological, and cosmetic findings were excellent in 40 (80%) patients. Restricture developed in one of 10 bulbar, five of 31 bulbopenile, and four of nine penile strictures. These all occurred in the first 6 mo postoperatively. All patients with recurrences needed further therapy, but there has been no additional recurrence observed to date. No complications such as fistula, wound infection, UTI, or rejection were observed.Conclusions: Use of inert porcine SIS matrix appears to be beneficial for patients with bulbar and bulbopenile strictures. Midterm results are comparable to skin flaps and mucosal grafts. (C) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved.