Datta Biswajit, Rao M P, Acharya R L, Goel N, Saxena Vaibhav, Trivedi S, Dwivedi U S, Singh P B
Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Int Braz J Urol. 2007 Mar-Apr;33(2):181-6; discussion 186-7. doi: 10.1590/s1677-55382007000200008.
To assess the success of buccal mucosal graft (BMG) urethroplasty by the dorsal onlay technique in long anterior urethral stricture (> 2 cm long) through the midline perineal incision.
From January 1998 to December 2003, 43 patients with long anterior urethral strictures were managed by dorsal onlay BMG urethroplasty. After voiding trial, they were followed up at 3 months with uroflowmetry, retrograde urethrogram (RGU) and American Urological Association symptoms score (AUA symptoms scores). Successful outcome was defined as normal voiding with a maximum one attempt of visual internal urethrotomy (VIU) after catheter removal. Patients were further followed-up with uroflowmetry at 3 months interval and RGU every 6 months interval.
Mean stricture length was 4.8 cm (range 3 to 9 cm) and mean follow up was 48 months (range 12 to 84 months). Only five patients were found to develop stricture at anastomotic site, during follow-up. Two of them voided normally after single attempt of VIU. Other three patients (6.9%) required further open surgery or repeat VIU during follow up and were considered as failure.
Dorsal onlay BMG urethroplasty is a simple technique with good surgical outcome.
评估经会阴中线切口采用背侧镶嵌法颊黏膜移植（BMG）尿道成形术治疗长段前尿道狭窄（长度>2 cm）的成功率。
1998年1月至2003年12月，43例长段前尿道狭窄患者接受了背侧镶嵌BMG尿道成形术。排尿试验后，在3个月时对患者进行尿流率测定、逆行尿道造影（RGU）及美国泌尿外科学会症状评分（AUA症状评分）随访。成功的标准定义为拔除导尿管后最大一次直视内尿道切开术（VIU）尝试后能正常排尿。患者每隔3个月进行尿流率测定随访，每隔6个月进行RGU随访。
平均狭窄长度为4.8 cm（范围3至9 cm），平均随访时间为48个月（范围12至84个月）。随访期间，仅5例患者在吻合口处出现狭窄。其中2例经单次VIU尝试后能正常排尿。另外3例患者（6.9%）在随访期间需要进一步的开放手术或重复VIU，被视为失败。
背侧镶嵌BMG尿道成形术是一种操作简单、手术效果良好的技术。
