Paulhac P, Fourcade L, Lesaux N, Alain J L, Colombeau P
Service d'Urologie, CHU Limoges, France.
BJU Int. 2003 Sep;92(5):506-9. doi: 10.1046/j.1464-410x.2003.04380.x.
Obstructive lesions of the anterior urethra (valves, diverticula) are rare and can be difficult to diagnose. One recent case led us to review existing international reports; there are case histories for 260 patients over a 20-year period. The anatomical interpretation of these lesions is far from being unequivocal but many authors clearly distinguish between valves and diverticula, the basic difference being in the contiguity between the anomaly and the corpus spongiosum. Where the clinical presentation depends on age, the diagnosis depends essentially on voiding cysto-urethrography, which must image the whole urethra. Generally, the treatment for valves is simple, consisting of endoscopic resection. For diverticula it is not always necessary or desirable to remove the diverticulum; if there is a well-formed distal obstructing lip, removing it may be enough to cure the obstruction.
前尿道梗阻性病变(瓣膜、憩室)较为罕见,诊断可能存在困难。近期的一个病例促使我们查阅现有的国际报告,其中有260例患者20年期间的病历。这些病变的解剖学解释远非明确,但许多作者明确区分了瓣膜和憩室,其基本区别在于异常与海绵体之间的连续性。临床表现取决于年龄,诊断主要依赖排尿性膀胱尿道造影,该检查必须对整个尿道成像。一般来说,瓣膜的治疗较为简单,采用内镜下切除术。对于憩室,并不总是需要或适宜切除憩室;如果存在形态良好的远端梗阻性唇状结构,切除它可能就足以治愈梗阻。