Chong Yew-Lam, Toh Khai-Lee
Urology Unit, Department of Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, Republic of Singapore.
Int Urol Nephrol. 2007;39(2):505-9. doi: 10.1007/s11255-006-9083-8. Epub 2007 Feb 22.
The outcome of urethroplasty for the anterior urethral stricture is superior to internal urethrotomy. However, the excellent results are often reported by tertiary medical centres and most urologists in general urological practice do not offer urethroplasty. We review the results of our institution to ascertain whether equivalent results are achievable in a district hospital urology service.
Over a 22-month period, 26 urethroplasties were performed. Mean age was 44.2 years (range: 16-83 years) and median follow-up was 14.6 months (range: 0.6-40.2 months). Anastomotic repair was performed in five, substitution urethroplasty in 15 (nine flaps and six grafts) and staged urethroplasty in 6. Length of strictures ranged from less than 0.2 cm to greater than 10 cm.
Stricture-free rate of 90.5% at 1 year was observed. Only two cases developed repeat stricture formation. Other minor complications included one epididymo-orchitis and one haematoma.
Good early outcome for urethroplasty for anterior urethral strictures is achievable in a district hospital practice. Keys to good outcome include having a dedicated team and a wide repertoire of urethral reconstructive techniques.
前尿道狭窄的尿道成形术效果优于尿道内切开术。然而，三级医疗中心常报告出色的结果，而大多数普通泌尿外科实践中的泌尿科医生并不提供尿道成形术。我们回顾了本机构的结果，以确定在地区医院泌尿外科服务中是否能取得同等的效果。
在22个月的时间里，进行了26例尿道成形术。平均年龄为44.2岁（范围：16 - 83岁），中位随访时间为14.6个月（范围：0.6 - 40.2个月）。5例行吻合修复术，15例行替代尿道成形术（9例皮瓣和6例移植），6例行分期尿道成形术。狭窄长度从小于0.2厘米到大于10厘米不等。
观察到1年时无狭窄率为90.5%。仅2例出现复发性狭窄形成。其他轻微并发症包括1例附睾炎和1例血肿。
在地区医院实践中，前尿道狭窄的尿道成形术可取得良好的早期效果。取得良好效果的关键包括拥有专业团队和多种尿道重建技术。
