Sa Ying-long, Xu Yue-min, Jin San-bao, Qiao Yong, Xu You-zhang, Wu Deng-long, Zhang Jiong
Department of Urology, Sixth People's Hospital, Jiaotong University of Shanghai, Shanghai 200233, China.
Zhonghua Wai Ke Za Zhi. 2006 Sep 15;44(18):1244-7.
To evaluate the various operative details of strictures of the posterior urethra that are essential for a successful result.
The clinical data of 191 patients with posterior urethral strictures or distraction defects from January 1990 to January 2006 were analyzed retrospectively. All patients underwent a retrograde and voiding urethrogram, 62 patients had urethral ultrasonography, 48 patients had urethroscopy, 3 patients had MRI. Repair was performed with a simple anastomosis after urethral mobilization in 66 patients, separation of the corporeal bodies in 48 patients, separation of the corporeal bodies and inferior pubectomy in 30 patients, transpubic anastomosis in 18 patients, pull-through operation in 3 patients, and optical urethrotomy in 26 patients. Followup ranged from 6 to 48 months.
The mean stricture length was 3.6 cm (range from 1.5 to 8.0 cm). Posterior urethral strictures is in 31 (16%), posterior distraction defects is in 160 (84%), of which the length of the distraction defects < 3 cm is in 102 (53.4%), and the the length of the distraction defects > 3 cm is in 58 (30.6%). The overall successful results (Qmax > 15 ml/s) after operation was 84.3%. Optical urethrotomy was 69%, the successful results with anastomotic urethroplasty were 97% with a simple anastomosis; 79% with separation of the corporeal bodies; 80% with separation of the corporeal bodies and inferior pubectomy; 83% with transpubic anastomosis; and 67% with pull-through operation.
The anastomotic urethroplasty is better than the optical urethrotomy, the length of the strictures or distraction defect which is lower than 3 cm is much more successfully corrected.
评估后尿道狭窄手术成功所需的各项操作细节。
回顾性分析1990年1月至2006年1月期间191例后尿道狭窄或断裂缺损患者的临床资料。所有患者均接受逆行排尿尿道造影，62例患者进行了尿道超声检查，48例患者进行了尿道镜检查，3例患者进行了磁共振成像。66例患者在尿道游离后行简单吻合修复，48例患者行海绵体分离，30例患者行海绵体分离及耻骨下支切除术，18例患者行经耻骨吻合术，3例患者行拖入式手术，26例患者行光学尿道切开术。随访时间为6至48个月。
平均狭窄长度为3.6 cm（范围为1.5至8.0 cm）。后尿道狭窄31例（16%），后尿道断裂缺损160例（84%），其中断裂缺损长度<3 cm者102例（53.4%），断裂缺损长度>3 cm者58例（30.6%）。术后总体成功结果（最大尿流率>15 ml/s）为84.3%。光学尿道切开术成功率为69%，吻合性尿道成形术的成功率为：简单吻合术97%；海绵体分离术79%；海绵体分离及耻骨下支切除术80%；经耻骨吻合术83%；拖入式手术67%。
吻合性尿道成形术优于光学尿道切开术，狭窄或断裂缺损长度低于3 cm者矫正成功率更高。
