Barbagli G, Sansalone S, Romano G, Lazzeri M
Center for Reconstructive Urethral Surgery, Arezzo, Italy.
Minerva Urol Nefrol. 2011 Sep;63(3):251-60.
Urethral strictures are a frequent source of lower urinary tract symptoms in men. Open urethroplasty is regarded as the gold-standard treatment for urethral stricture disease. The treatment for urethral strictures is a continually evolving process and there is renewed controversy over the best approach to take in reconstructing the urethra, since the superiority of one approach over another has not yet been clearly defined. Anterior urethroplasty can be treated, with low morbidity, in an outpatient surgical setting, thus decreasing the impact of urethroplasty. In order to improve outcome in adult patients when the penile shaft is involved, reconstructive urethral surgeons have learned to apply the principles of delicate tissue handling, and the development of minimally invasive techniques. Genital or extra-genital skin has been used as a free graft or harvested as a flap for some time, thanks to its location, hairless skin and durability. Since the early 1990s, the use of oral mucosa was introduced in genital reconstructive surgery and has become popular for urethral reconstructions. Urethral reconstructive surgery is changing rapidly and this change has posed problems for surgeons who see the principles that previously defined their profession becoming obsolete or unworkable. New techniques and new engineered material are a part of our future.
尿道狭窄是男性下尿路症状的常见原因。开放性尿道成形术被视为尿道狭窄疾病的金标准治疗方法。尿道狭窄的治疗是一个不断发展的过程，对于重建尿道的最佳方法再次出现了争议，因为一种方法相对于另一种方法的优越性尚未明确界定。前尿道成形术可以在门诊手术环境中进行治疗，发病率较低，从而降低了尿道成形术的影响。为了提高成年患者阴茎体受累时的治疗效果，重建性尿道外科医生已学会应用精细组织处理原则，并开发了微创技术。由于其位置、无毛皮肤和耐用性，生殖器或生殖器外皮肤已被用作游离移植物或作为皮瓣采集一段时间了。自20世纪90年代初以来，口腔黏膜在生殖器重建手术中的应用被引入，并在尿道重建中变得流行。尿道重建手术正在迅速变化，这种变化给外科医生带来了问题，他们看到以前定义其职业的原则变得过时或不可行。新技术和新型工程材料是我们未来的一部分。
