Hosseini Jalil, Tavakkoli Tabassi Kamyar
Department of Urology, Reconstructive Urology Division, Shohada-e-Tajrish Hospital and Infertility and Reproductive Health Research Center, Shahid Beheshti University, MC, Tehran, Iran.
Urol J. 2008 Fall;5(4):215-22.
The main objective of the present review article was to study the different aspects of reconstructive surgery for posterior urethral defects by reviewing the published articles and presentation of our experiences in the reconstructive urology division at Shohada-e-Tajrish hospital.
The Medline was searched with the keywords of posterior urethroplasty, end-to-end anastomosis, excisional urethroplasty, anastomotic urethroplasty, pelvic fracture, bulboprostatic anastomosis, and urethral repair. The search was limited to papers published from 1980 to September 2008. We selected the relevant published articles in this database and also presented our experience at our reconstructive urology division.
Of over 5000 search results, we selected 38 relevant articles with substantial contribution to the subject. Pelvic fracture due to accidents was the most common etiology of pelvic fracture urethral distraction defect that usually involved the membranous urethra. Surgical treatment of this disorder with perineal anastomotic urethroplasty was accompanied by a success rate of 82% to 95% in different studies. The most important complications of this surgery include urinary incontinence and impotence; however, the incidence of these complications has been reduced by using new surgical techniques.
Complete preoperative assessment, the use of suitable reconstructive techniques, and in particular, the use of flexible cystoscopy can lead to acceptable outcomes of the surgical repair of pelvic fracture urethral distraction defects.
本综述文章的主要目的是通过回顾已发表的文章并介绍我们在塔吉里什烈士医院重建泌尿外科的经验，来研究后尿道缺损重建手术的不同方面。
在Medline数据库中以“后尿道成形术”“端端吻合术”“切除性尿道成形术”“吻合性尿道成形术”“骨盆骨折”“球部-前列腺吻合术”和“尿道修复”为关键词进行检索。检索范围限于1980年至2008年9月发表的论文。我们在该数据库中筛选了相关的已发表文章，并介绍了我们在重建泌尿外科的经验。
在5000多条检索结果中，我们选择了38篇对该主题有重大贡献的相关文章。事故导致的骨盆骨折是骨盆骨折尿道牵张缺损最常见的病因，通常累及膜部尿道。不同研究中，采用会阴吻合性尿道成形术治疗该疾病的成功率为82%至95%。该手术最重要的并发症包括尿失禁和阳痿；然而，通过使用新的手术技术，这些并发症的发生率有所降低。
完整的术前评估、使用合适的重建技术，尤其是使用可弯曲膀胱镜，可使骨盆骨折尿道牵张缺损的手术修复取得可接受的效果。
