Fenton Ann S, Morey Allen F, Aviles Ricardo, Garcia Carlos R
Urology Services, Brooke Army Medical Center, San Antonio, Texas 78234-6200, USA.
Urology. 2005 Jun;65(6):1055-8. doi: 10.1016/j.urology.2004.12.018.
To evaluate the etiology and characteristics of symptomatic anterior urethral strictures in a large series of men presenting for urologic treatment in an effort to determine the common themes that may influence possible prevention or treatment strategies. Many questions about the origin and features of contemporary anterior urethral stricture disease remain unanswered.
The records of 175 men with symptomatic anterior urethral strictures were reviewed. Data were entered both prospectively by careful patient questioning and retrospectively from detailed chart review. The stricture length, location, and cause were recorded from urologic presentation, before definitive treatment. Posterior strictures from pelvic fracture urethral disruption defects were excluded from this review.
A total of 194 strictures were identified in 175 men. Most strictures were idiopathic (65 of 194, 34%) or iatrogenic (63 of 194, 32%); fewer were inflammatory (38 of 194, 20%) or traumatic (28 of 194, 14%). Most involved the bulbar urethra (n = 100, 52%). Pendulous strictures (mean 6.1 cm) were longer on average than those in the fossa navicularis (mean 2.6 cm) or bulb (mean 3.1 cm). Prolonged catheterization (n = 26) and transurethral surgery (n = 25) were common causes of iatrogenic strictures.
Our results showed that idiopathic and iatrogenic strictures are surprisingly common. External trauma was a relatively uncommon cause of anterior urethral stricture disease overall. Unnecessary urethral catheterization and repeated urethral instrumentation should be avoided to prevent stricture formation or exacerbation. More study is necessary to determine the origin of anterior urethral stricture disease.
评估大量因泌尿系统疾病前来接受治疗的男性患者中症状性前尿道狭窄的病因及特征，以确定可能影响预防或治疗策略的共同主题。关于当代前尿道狭窄疾病的起源和特征仍有许多问题尚未得到解答。
回顾了175例有症状性前尿道狭窄男性患者的病历。数据通过仔细询问患者前瞻性录入，并通过详细查阅病历回顾性获取。在进行确定性治疗前，从泌尿外科检查记录中记录狭窄长度、位置和病因。本次回顾排除了骨盆骨折尿道断裂缺损导致的后尿道狭窄。
175名男性患者共发现194处狭窄。大多数狭窄为特发性（194处中的65处，34%）或医源性（194处中的63处，32%）；炎症性（194处中的38处，20%）或创伤性（194处中的28处，14%）较少。大多数狭窄累及球部尿道（n = 100，52%）。阴茎部狭窄（平均6.1 cm）平均比舟状窝狭窄（平均2.6 cm）或球部狭窄（平均3.1 cm）更长。长期留置导尿管（n = 26）和经尿道手术（n = 25）是医源性狭窄的常见原因。
我们的结果表明，特发性和医源性狭窄出奇地常见。总体而言，外部创伤是前尿道狭窄疾病相对少见的原因。应避免不必要的尿道插管和重复尿道器械操作，以防止狭窄形成或加重。需要更多研究来确定前尿道狭窄疾病的起源。
