联合管状后尿道成形术和筋膜包裹治疗神经源性括约肌功能障碍患者的控尿改善：延长、缩窄和收紧术。

Improved continence in patients with neurogenic sphincteric incompetence with combination tubularized posterior urethroplasty and fascial wrap: the lengthening, narrowing and tightening procedure.

机构信息

Department of Urology, David Geffen School of Medicine at University of California-Los Angeles and Robert Wood Johnson Clinical Scholars Program, University of California-Los Angeles and Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California 90095-1738, USA.

出版信息

J Urol. 2010 Oct;184(4 Suppl):1763-7. doi: 10.1016/j.juro.2010.03.080. Epub 2010 Aug 21.

DOI:10.1016/j.juro.2010.03.080

PMID:20728163

Abstract

PURPOSE

We evaluated the outcome in 19 patients who underwent bladder neck reconstruction by lengthening, narrowing and tightening the bladder neck with a combined tubularized posterior urethroplasty and circumferential fascial wrap.

MATERIALS AND METHODS

We reviewed the records of all patients who underwent bladder neck lengthening, narrowing and tightening between April 1996 and November 2002. Preoperative urodynamic and radiographic data were available on all patients. The surgical technique involved retroperitoneal exposure of the bladder neck with a tubularized posterior urethroplasty over a urethral catheter. The reconstructed urethra was then circumferentially wrapped with a fitted piece of cadaveric fascia.

RESULTS

Of the 19 patients 15 remain completely continent at a mean ± SD followup of 35.5 ± 29.1 months. Three patients underwent secondary reconstruction, including bladder neck ligation in all 3 and secondary enterocystoplasty in 2. No patient experienced difficult intermittent catheterization via the urethra postoperatively.

CONCLUSIONS

Bladder neck lengthening, narrowing and tightening is effective for managing neurogenic sphincteric incontinence. Outcomes are comparable with those of other reconstructive procedures.

摘要