Anastomotic urethroplasty for bulbar urethral stricture: Analysis of 168 patients
Anastomotic urethroplasty for bulbar urethral stricture: Analysis of 168 patients
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DOI：
10.1016/s0022-5347(05)65184-1
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发表时间：
2002-04-01
影响因子：
6.6
通讯作者：
McAninch, JW
中科院分区：
文献类型：
--
作者：
Santucci, RA;Mario, LA;McAninch, JW
目的：我们回顾了我们的经验，吻合尿道成形术治疗前尿道狭窄。材料和方法：一个图表审查显示168例患者6至82岁（平均年龄38岁），至少6个月的后续行动（平均70，范围6至291）后吻合尿道成形术。结果：平均狭窄长度为1.7厘米。在168例患者中，8例（5%）狭窄复发，但5例采用直视下尿道内切开术或单次扩张术治疗，3例（2%）需要再次尿道成形术。在这3例病例中，情有可原的情况包括患者导管移位并试图更换导管，从而破坏修复，有尿道皮肤瘘和尿道周围脓肿病史，以及既往辐照导致狭窄并发症各1例。其他并发症不常见，如3例（2%）患者出现暂时性大腿疼痛或麻木，2例（1%）患者出现小伤口裂开，1例（<1%）患者出现阴囊血肿、勃起功能障碍和自限性肺水肿。它在技术上是简单的，并发症是罕见的。吻合尿道成形术的治愈应强烈优于直视下尿道内切开术或尿道扩张术的长期治疗。
Purpose: We reviewed our experience with anastomotic urethroplasty for anterior urethral stricture.Materials and Methods: A chart review revealed 168 patients 6 to 82 years old (mean age 38) with at least 6 months of followup (mean 70, range 6 to 291) after anastomotic urethroplasty.Results: Average stricture length was 1.7 cm. Of the 168 patients stricture recurred in 8 (5%) but was managed by direct vision internal urethrotomy or a single dilation in 5, while repeat urethroplasty was required in 3 (2%). In these 3 cases extenuating circumstances included patient dislodgment of the catheter with attempts to replace it that disrupted repair, a history of urethrocutaneous fistula and periurethral abscess, and previous irradiation complicating the stricture in 1 each. Other complications were uncommon, such as transient thigh pain or numbness in 3 patients (2%), small wound dehiscence in 2 (1%), and scrotal hematoma, erectile dysfunction and self-limited pulmonary edema in 1 (less than 1%) each.Conclusions: Anastomotic urethroplasty for anterior stricture has a high success rate of 95%. It is technically straightforward and complications are uncommon. Cure by anastomotic urethroplasty should be strongly favored over long-term management by direct vision internal urethrotomy or dilation.