Singh Santosh K, Pawar Devendra S, Khandelwal Atul K
Department of Urology, Pt. B. D. Sharma University of Health Sciences, Rohtak, Haryana, India.
Urol Ann. 2010 May;2(2):53-7. doi: 10.4103/0974-7796.65104.
We present our experience with transperineal bulboprostatic anastomosis procedure and compare the results with age of patients, length of urethral stricture, effect of previous treatment and need for ancillary procedures.
We retrospectively reviewed the outcome of 172 patients who underwent perineal urethroplasty procedure for traumatic stricture in our institute. Simple perineal anastomosis was done in 92 patients. Perineal anastomosis and corporal separation were done in 52 patients. Perineal anastomosis with inferior pubectomy was done in 25 patients. Perineal anastomosis with rerouting was done in three patients. Age, prior treatment, length of stricture, and ancillary techniques required during reconstruction were compiled. The clinical outcome was considered as failure when any postoperative instrumentation was needed.
Out of 172 cases that underwent transperineal urethroplasty procedure, 157 (91.28%) were successful. Simple perineal urethroplasty procedure showed a success rate of 93.4%, perineal anastomosis with separation of corporal bodies had a success rate of 90.4%, perineal anastomosis with inferior pubectomy had a success rate of 88% and perineal anastomosis with rerouting of urethra around the corpora had a success rate of 66.7%.
The success rate of delayed progressive perineal urethroplasty procedure for post-traumatic stricture urethra is excellent and majority of the failures occurs in prepubescent boys and in those undergoing secondary repair.
我们介绍经会阴球部前列腺吻合术的经验,并将结果与患者年龄、尿道狭窄长度、既往治疗效果及辅助手术需求进行比较。
我们回顾性分析了我院172例因创伤性狭窄接受会阴尿道成形术患者的治疗结果。92例行单纯会阴吻合术,52例行会阴吻合术及阴茎海绵体分离术,25例行会阴吻合术及耻骨下切除术,3例行会阴吻合术及尿道改道。收集患者年龄、既往治疗情况、狭窄长度及重建过程中所需的辅助技术。若术后需要任何器械操作,则临床结果视为失败。
172例接受经会阴尿道成形术的患者中,157例(91.28%)成功。单纯会阴尿道成形术成功率为93.4%,会阴吻合术联合阴茎海绵体分离术成功率为90.4%,会阴吻合术联合耻骨下切除术成功率为88%,会阴吻合术联合尿道绕阴茎海绵体重建术成功率为66.7%。
创伤性尿道狭窄延迟渐进性会阴尿道成形术成功率很高,大多数失败发生在青春期前男孩及接受二次修复的患者中。