Xu Yue-Min, Sa Ying-Long, Fu Qiang, Zhang Jiong, Si Jie-Min, Liu Zhang-Shun
Department of Urology, Sixth People's Hospital, Jiaotong University of Shanghai, 200233 Shanghai, China.
World J Urol. 2009 Aug;27(4):565-71. doi: 10.1007/s00345-009-0378-0. Epub 2009 Feb 13.
To evaluate the efficacy and safety of using oral mucosal grafts for urethroplasty in the treatment of complex segmented urethral strictures.
Between January 2002 and January 2008, 25 cases of long or multi-segmented urethral strictures (10-18 cm, mean 11.72) were treated using combined two oral mucosal graft urethroplasty. Of the 25 patients, combined double buccal mucosal graft (BMG) urethroplasty was performed in nine patients, double lingual mucosal graft (LMG) urethroplasty in seven patients and combined lingual and buccal mucosal graft urethroplasty in nine patients.
Follow-up was obtained for 6-72 months (mean 26.83) post-operatively. Urethrocutaneous fistulas developed in two patients. Urethral strictures developed in one patient undergoing BMG urethroplasty; the patient underwent five urethral dilations, after which he voided well with a urinary peak flow of 26.4 ml/s. Meatal stenosis developed in one patient undergoing LMG and a second operation was required, after which the patient voided well (urinary peak flow of 28.7 ml/s). The other patients voided well and urinary peak flow rates ranged from 16.8 to 49.2 ml/s (mean 28.65 ml/s).
Combined two oral mucosal grafts substitution urethroplasty is an effective technique for the treatment of long, segmented urethral strictures.
评估使用口腔黏膜移植物进行尿道成形术治疗复杂性节段性尿道狭窄的疗效和安全性。
2002年1月至2008年1月，对25例长段或多节段尿道狭窄（10 - 18厘米，平均11.72厘米）患者采用联合两片口腔黏膜移植物尿道成形术进行治疗。25例患者中，9例行联合双侧颊黏膜移植物（BMG）尿道成形术，7例行双侧舌黏膜移植物（LMG）尿道成形术，9例行舌黏膜与颊黏膜联合移植物尿道成形术。
术后随访6 - 72个月（平均26.83个月）。2例患者出现尿道皮肤瘘。1例行BMG尿道成形术的患者发生尿道狭窄；该患者接受了5次尿道扩张，之后排尿良好，尿流率峰值为26.4毫升/秒。1例行LMG尿道成形术的患者出现尿道口狭窄，需再次手术，术后排尿良好（尿流率峰值为28.7毫升/秒）。其他患者排尿良好，尿流率峰值在16.8至49.2毫升/秒之间（平均28.65毫升/秒）。
联合两片口腔黏膜移植物替代尿道成形术是治疗长段节段性尿道狭窄的有效技术。
