Department of Urology, Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China.
Chin Med J (Engl). 2010 Feb 20;123(4):458-62.
Urethroplasty of complex urethral stricture is a difficult procedure, and there is no widely accepted standard approach described in the published literature. We evaluated the efficacy and safety of urethroplasty using lingual mucosa grafts (LMGs) for the repair of urethral strictures.
Between August 2006 and April 2009, 92 cases of urethral strictures (length ranging from 2.5 cm to 18 cm, mean 6.5 cm) were treated using LMGs. Of the 92 patients, 38 with long-segment urethral strictures (9 - 18 cm) underwent dual LMG or LMG combined with foreskin flap or buccal mucosal graft urethroplasty.
Follow-up was obtained for 3 - 33 months (mean 17.2 months) postoperatively. Complications occurred in 8 patients, including urinary fistulas in 4 patients; recurrent strictures developed in 4 patients at 3 - 4 months post-operatively. The remaining patients voided well postoperatively, with peak flows between 14.3 ml/s and 54.6 ml/s (mean 28.4 ml/s).
The tongue is an excellent source of graft material for the repair of anterior mucosal strictures. Dual LMG substitution urethroplasty can successfully treat longer, more complex urethral strictures.
复杂性尿道狭窄的尿道成形术是一个具有挑战性的手术，目前发表的文献中也没有被广泛接受的标准方法。我们评估了使用舌黏膜移植物（LMG）修复尿道狭窄的疗效和安全性。
2006 年 8 月至 2009 年 4 月，92 例尿道狭窄患者（长度 2.5 至 18cm，平均 6.5cm）采用 LMG 进行治疗。其中 38 例长段尿道狭窄（9 至 18cm）患者行双 LMG 或 LMG 联合包皮瓣或颊黏膜移植物尿道成形术。
术后随访 3 至 33 个月（平均 17.2 个月）。8 例患者发生并发症，其中 4 例出现尿瘘；4 例患者术后 3 至 4 个月复发狭窄。其余患者术后排尿良好，最大尿流率为 14.3 至 54.6ml/s（平均 28.4ml/s）。
舌是修复前尿道黏膜狭窄的良好移植物来源。双 LMG 替代尿道成形术可成功治疗更长、更复杂的尿道狭窄。
