Department of Urology, Shanghai 6th Hospital, Shanghai, China.
BJU Int. 2011 Oct;108(8):1352-4. doi: 10.1111/j.1464-410X.2011.10079.x. Epub 2011 Feb 18.
• To evaluate the management of traumatic posterior urethral stricture associated with false passage, as this remains a challenge for urologists.
• From January 2000 to February 2010, 19 patients (mean (range) age 34 [25-52] years) with traumatic posterior urethral obliteration associated with false passage were evaluated and treated at our centre. • All patients underwent perineal excision and primary anastomotic urethroplasty using cystoscopy by the suprapubic route to insert a guidewire into the original bladder neck, allowing exposure of the normal posterior urethra. • Patients underwent voiding cysto-urethrography 1 month after the procedure. When symptoms of decreased force of stream were present and uroflowmetry was <15 mL/s, urethrography and urethroscopy were repeated. • Clinical outcome was considered a failure when any postoperative instrumentation was needed, including dilatation.
• The mean (range) follow-up was 12 (9-14) months. The overall success rate was 84%. • Three patients (16%) with persistent voiding difficulty developed a short anastomotic stricture 1-3 months after surgery. • The mean maximum urinary flow rate after surgery was 20.01 mL/s and no patient had urinary incontinence.
• The preoperative use of flexible cystoscopy via the suprapubic route represented a successful key point of urethroplasty for posterior urethral stricture associated with false passage.
评估外伤性后尿道狭窄合并假道的处理方法，因为这对泌尿科医生来说仍然是一个挑战。
在 2000 年 1 月至 2010 年 2 月期间，我们中心评估并治疗了 19 例（平均年龄 34 岁[25-52 岁]）外伤性后尿道完全闭塞伴假道的患者。所有患者均采用耻骨上经膀胱途径的软性膀胱镜行会阴部切除和一期吻合尿道成形术，将导丝插入原膀胱颈部，暴露正常的后尿道。术后 1 个月行排尿性膀胱尿道造影。当出现尿流力减弱的症状且尿流率<15ml/s 时，重复进行尿道造影和尿道镜检查。当需要任何术后器械处理，包括扩张时，临床结果被认为是失败。
平均随访时间为 12 个月[9-14 个月]。整体成功率为 84%。3 名（16%）有持续性排尿困难的患者在术后 1-3 个月出现短段吻合口狭窄。术后最大尿流率平均为 20.01ml/s，无患者发生尿失禁。
术前经耻骨上途径使用软性膀胱镜是治疗后尿道狭窄合并假道的成功关键。
