Gupta N P, Mishra S, Dogra P N, Hemal A K, Seth A, Kumar R
Department of Urology, All India Institute of Medical Sciences, New Delhi, India.
Urol Int. 2009;82(2):179-82. doi: 10.1159/000200796. Epub 2009 Mar 19.
We review our experience of end-to-end urethroplasty for urethral strictures performed during the last 6 years.
From September 2001 to December 2006, 138 male patients underwent anastomotic urethroplasty at our center. Mean age was 28.1 years (range 6-71), average stricture length was 2.2 cm (range 0.7-6.0). One hundred and one patients (73.2%) had obliterative stricture while 37 (26.8%) still had some urethral passage. Ninety (65.2%) had a history of previous intervention. Sixty patients (43.5%) had associated complicating factors like urethrocutaneous fistula, rectourethral fistula, vesical calculus, blind tract and cavities, bony deformity, or urinary tract infection.
The mean operative time was 92 min (range 60-240). Average follow-up was 26.7 months (range 6-60). One hundred and fourteen (82.6%) had excellent outcome, 18 (13%) had acceptable outcome and 6 (4.3%) failed to respond. Seventeen patients developed complications: 5 developed wound infection, 3 epididymorchitis, 2 failed to void, 2 each had incontinence and perineal hematoma, and 1 each had erectile dysfunction, accidentally pulled his catheter out and had urethrocutaneous fistula.
End-to-end urethroplasty is an ideal procedure for managing strictures of bulbous and posterior urethra in properly selected cases.
回顾我们在过去6年中进行的尿道狭窄端端尿道成形术的经验。
2001年9月至2006年12月,138例男性患者在我们中心接受了吻合性尿道成形术。平均年龄为28.1岁(范围6 - 71岁),平均狭窄长度为2.2厘米(范围0.7 - 6.0厘米)。101例患者(73.2%)为闭塞性狭窄,而37例(26.8%)仍有部分尿道通道。90例(65.2%)有既往干预史。60例患者(43.5%)有相关并发症,如尿道皮肤瘘、直肠尿道瘘、膀胱结石、盲管和腔隙、骨质畸形或尿路感染。
平均手术时间为92分钟(范围60 - 240分钟)。平均随访时间为26.7个月(范围6 - 60个月)。114例(82.6%)效果极佳,18例(13%)效果尚可,6例(4.3%)效果不佳。17例患者出现并发症:5例发生伤口感染,3例发生附睾炎,2例排尿困难,2例分别出现尿失禁和会阴部血肿,1例分别出现勃起功能障碍、意外拔管和尿道皮肤瘘。
端端尿道成形术是在适当选择的病例中治疗球部和后尿道狭窄的理想手术方法。