SIU/ICUD Consultation on Urethral Strictures: Anterior Urethra - Primary Anastomosis
SIU/ICUD Consultation on Urethral Strictures: Anterior Urethra - Primary Anastomosis
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DOI：
10.1016/j.urology.2013.11.007
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发表时间：
2014-03-01
期刊：
影响因子：
2.1
通讯作者：
Giudice, Carlos
中科院分区：
文献类型：
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作者：
Morey, Allen F.;Watkin, Nick;Giudice, Carlos
原发性和复发性球尿道狭窄疾病的治疗一直是内镜尿道切开术和开放尿道成形术之间选择的争议来源。进一步的争论存在于选择尿道成形术——要么切除和原发性吻合（EPA），要么用移植物或皮瓣增加。利用PubMed，我们进行了一项长达35年（1975-2010）的文献检索，检索了关于使用EPA治疗球茎狭窄的同行评议文章。排除包括< 10例患者、重复、综述或队列混合且不能单独分析数据的文章。17篇文章符合标准，共1234例患者。总体成功率为93.8%。报告的并发症< 5%，且无持续性性功能丧失的证据。作者得出结论，EPA与高成功率和低并发症发生率相关。我们的建议是，当其他手术的预期成功率< 90%时，它应该在短期孤立性球狭窄的患者中进行。(C) 2014爱思唯尔公司
The management of primary and recurrent bulbar urethral stricture disease has been a source of controversy with the choice being between endoscopic urethrotomy and open urethroplasty. Further debate exists with regard to the choice of urethroplasty-either excision and primary anastomosis (EPA) or augmentation with a graft or flap. Using PubMed, a 35-year literature search was conducted (1975-2010) for peer-reviewed articles on bulbar strictures treated using EPA. Exclusions included articles with < 10 patients, duplications, reviews, or in which the cohort was mixed and the data could not be separately analyzed. Seventeen articles fulfilled the criteria with a total of 1234 patients. Overall success was 93.8%. Reported complications were < 5%, and there was no evidence of persistent loss of sexual function. The authors conclude that EPA is associated with a high success rate with low complication rate. Our recommendation is that it should be performed in patients with short isolated bulbar strictures, when expected success rates of other procedures are < 90%. (C) 2014 Elsevier Inc.