Malone Peter
Harold Hopkins Department of Urology, Royal Berkshire Hospital, Reading, United Kingdom.
J Urol. 2004 Sep;172(3):949-52. doi: 10.1097/01.ju.0000134781.43470.5f.
A novel technique is described to relieve stenosis of a ventrally placed or pinhole external urinary meatus in men and boys with lichen sclerosus.
A total of 19 patients underwent the new operation in a 5-year period. Mean patient age was 42.2 years (range 6 to 74) and mean followup was 3 years 9 months (range 18 months to 6 years 7 months). The operation involves dorsal and ventral meatotomies with an inverted V-shaped relieving incision to correct puckering caused by dorsal meatotomy. Patients were mailed a questionnaire asking if they were pleased with the cosmetic results, and how often and how much they sprayed when passing urine.
Two patients died of unrelated causes and 2 were lost to followup. There were no recurrences or major complications. A total of 13 patients replied to the questionnaires. All patients were pleased or very pleased with the cosmetic result. Most patients (11 of 13 or 85%) did not spray at all or, if they did, only sprayed occasionally. No patient found it constant or severe.
The technique relieves stenosis of the external urinary meatus in the medium term. It is rapid and easy to perform on an outpatient basis and it provides good cosmesis with a low incidence of a spraying stream. Because the main axis of the operation is dorsal, it does not create a hypospadiac meatus.
描述一种治疗患有硬化性苔藓的男性和男孩腹侧型或针孔型外尿道口狭窄的新技术。
5年间共有19例患者接受了这种新手术。患者平均年龄为42.2岁（范围6至74岁），平均随访时间为3年9个月（范围18个月至6年7个月）。该手术包括背侧和腹侧尿道口切开术，以及一个倒V形减压切口，以纠正背侧尿道口切开术引起的皱缩。通过邮件向患者发送问卷，询问他们对外观效果是否满意，以及排尿时喷射尿液的频率和程度。
2例患者死于无关原因，2例失访。无复发或严重并发症。共有13例患者回复了问卷。所有患者对外观效果感到满意或非常满意。大多数患者（13例中的11例，即85%）根本不喷射尿液，或者即便喷射，也只是偶尔喷射。没有患者认为这是持续或严重的问题。
该技术可在中期缓解外尿道口狭窄。它操作快速简便，可在门诊进行，外观效果良好，尿液喷射发生率低。由于手术的主要切口在背侧，不会造成尿道下裂尿道口。
