Raber Marco, Naspro Richard, Scapaticci Emanuele, Salonia Andrea, Scattoni Vincenzo, Mazzoccoli Bruno, Guazzoni Giorgio, Rigatti Patrizio, Montorsi Francesco
Department of Urology, University Vita Salute San Raffaele, Milan, Italy.
Eur Urol. 2005 Dec;48(6):1013-7. doi: 10.1016/j.eururo.2005.05.003. Epub 2005 May 31.
To compare the outcomes of dorsal onlay graft urethroplasty using penile skin (PS) or buccal mucosa (BM) free grafts in the repair of adult bulbourethral strictures.
From January 1998 to March 2003, 30 patients with bulbar urethral strictures underwent urethral reconstruction with PS (17) or with BM free graft (13). Follow-up was done at 6, 12 and 18 months postoperatively, and every year subsequently. Success was defined as normalization of IPSS and a stable Q(max) value >20 ml/s. Any further instrumentation for stricture recurrence was considered a failure.
Mean follow-up was 51 months (20-74). The overall success rate was 80% (85% in the BM and 76% in the PS group). Improvement of uroflowmetry, IPSS and QoL did not show a significant difference between the two groups. A significant improvement of the orgasmic function domain of the IIEF was found in patients treated with a PS graft. Post-operative complications were lip hypoesthesia (30%), retraction of the ventral skin of the penis (7%), post-voiding dribbling (8% with BM graft, and 7%, with PS graft). Six patients, 2 with BM (15%) and 4 with PS graft patch (24%) required further treatment due to stricture recurrence.
Results of PS or BM graft are comparable at 18 month follow-up, although orgasmic function is significantly improved in patients receiving a PS graft. Nevertheless, with extended follow-up, the use of PS seems to be associated with a higher failure rate.
比较采用阴茎皮肤（PS）游离移植或颊黏膜（BM）游离移植的背侧镶嵌植片尿道成形术修复成人球部尿道狭窄的效果。
1998年1月至2003年3月，30例球部尿道狭窄患者接受了PS（17例）或BM游离移植（13例）的尿道重建术。术后6、12和18个月进行随访，此后每年随访一次。成功定义为国际前列腺症状评分（IPSS）正常且最大尿流率（Qmax）稳定值>20 ml/s。任何因狭窄复发而进行的进一步器械治疗均视为失败。
平均随访51个月（20 - 74个月）。总体成功率为80%（BM组为85%，PS组为76%）。两组间尿流率、IPSS和生活质量的改善无显著差异。接受PS移植治疗的患者在国际勃起功能指数（IIEF）的性高潮功能领域有显著改善。术后并发症包括唇部感觉减退（30%）、阴茎腹侧皮肤回缩（7%）、排尿后滴沥（BM移植组为8%，PS移植组为7%）。6例患者因狭窄复发需要进一步治疗，其中2例为BM移植（15%），4例为PS移植补片（24%）。
在18个月的随访中，PS或BM移植的效果相当，尽管接受PS移植的患者性高潮功能有显著改善。然而，随着随访时间延长，使用PS似乎与更高的失败率相关。
