Tkachuk V N, Komiakov B K
Urol Nefrol (Mosk). 1990 Nov-Dec(6):59-62.
The authors reviewed the results of surgical management of 233 patients aged 8-76 years who had suffered urethral strictures. A total of 266 operations were made in the period of 1970-1989. Urethral tunneling which had been widely used in clinical practice for strictures of the urethra until 1980 yielded 91.2% recurrences of the disease, which made surgeons modify the surgical policy. During the past decade 127 patients with urethral strictures and obliterations have undergone 138 surgical interventions: 91 (65.9%) urethral resections, 34 (24.6%) internal optical urethrotomies and transurethral resections of scarring tissue, 7 (5.1%) cutaneous urethral plastic surgeries and only 6 (4.4%) urethral tunnelings. The number of relapses was reduced to 13.4%. The authors consider that urethral resection should be the operation of choice in urethral strictures and obliterations. Endoscopic treatment techniques (urethrotomy and transurethral resection) are indicated in short strictures and scarring deformity of the posterior urethra after prostate operation. It is advisable to apply cutaneous urethral plastic surgery in case of extended strictures.
作者回顾了233例年龄在8至76岁之间的尿道狭窄患者的手术治疗结果。在1970年至1989年期间共进行了266次手术。直到1980年,尿道隧道术在临床实践中广泛用于尿道狭窄,其疾病复发率达91.2%,这促使外科医生改变手术策略。在过去十年中,127例尿道狭窄和闭锁患者接受了138次手术干预:91例(65.9%)尿道切除术,34例(24.6%)内镜下尿道内切开术及经尿道瘢痕组织切除术,7例(5.1%)皮肤尿道成形术,仅6例(4.4%)尿道隧道术。复发率降至13.4%。作者认为尿道切除术应是尿道狭窄和闭锁的首选手术。内镜治疗技术(尿道内切开术和经尿道切除术)适用于前列腺手术后后尿道的短段狭窄和瘢痕畸形。对于广泛性狭窄,宜采用皮肤尿道成形术。