Dalela Divakar, Sinha Rahul Janak, Sankhwar Satya Narayan, Singh Vishwajeet
Department of Urology, CSMMU, Lucknow, (UP), India.
Urol J. 2010 Jun 10;7(2):115-9.
Complication rates with ventral onlay technique of oral mucosa graft urethroplasty have been attributed to the poor ventral support for the graft. We herein describe a new technique which overcomes these problems and also discuss the short-term follow-up.
In a prospective study conducted between January 2006 and June 2008, 13 patients with proximal stricture of the bulbar urethra underwent ventral bulbar augmentation. In this technique, the graft was sutured only to the bulbar urethra and the rest of spongiosal tissue was closed superficially. Longitudinal incisions were given in the partial depth of the bulb, adjacent to the suture line and were sutured together over the first suture line.
The mean follow-up period was 16.4 months (range, 6 to 30 months). Two of the patients developed restricture; one at the proximal anastomosis of the graft with native urethra and one at the distal anastomosis. Remaining 11 patients have satisfactory postoperative uroflow rates and are doing well. The success rate at the last follow-up was 84.6%.
This technique exploits the local bulbar anatomy by successfully moving the lateral bulbar tissue medially, below the ventrally placed mucosal graft. This results in a thicker ventral bulbar platform which provides enhanced support to the graft.
口腔黏膜移植尿道成形术腹侧覆盖技术的并发症发生率被认为是由于移植物腹侧支撑不足。我们在此描述一种克服这些问题的新技术，并讨论短期随访情况。
在2006年1月至2008年6月进行的一项前瞻性研究中，13例球部尿道近端狭窄患者接受了球部腹侧增厚术。在该技术中，移植物仅缝合至球部尿道，其余海绵体组织浅层缝合。在球部部分深度、靠近缝线处做纵向切口，并在第一条缝线之上缝合在一起。
平均随访期为16.4个月（范围6至30个月）。2例患者出现狭窄，1例在移植物与原尿道近端吻合处，1例在远端吻合处。其余11例患者术后尿流率满意，情况良好。最后一次随访时成功率为84.6%。
该技术通过成功地将球部外侧组织向内侧移动至腹侧放置的黏膜移植物下方，利用了球部局部解剖结构。这导致形成更厚的球部腹侧平台，为移植物提供更好的支撑。
