Pfalzgraf D, Häcker A
Klinik für Urologie, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68157 Mannheim, Deutschland.
Urologe A. 2013 May;52(5):657-61. doi: 10.1007/s00120-013-3116-6.
The most commonly used treatment modality for urethral strictures is the direct visual internal urethrotomy (DVUI) method according to Sachse. It is an effective short-term treatment, but the long-term success rate is low. A number of factors influence the outcome of DVUI including stricture location, spongiofibrosis and previous endoscopic stricture treatment. Multiple urethrotomy has a negative impact on the success rate of subsequent urethroplasty. A thorough preoperative diagnostic work-up including combined retrograde urethrogram/voiding cystourethrogram (RUG/VCUG) and urethrocystoscopy is, therefore, mandatory to allow for patient counselling regarding the risk of stricture recurrence and other treatment options. After a failed primary DVUI, subsequent urethrotomy cannot be expected to be curative.
根据萨克塞的观点，尿道狭窄最常用的治疗方式是直视下内尿道切开术（DVUI）。这是一种有效的短期治疗方法，但长期成功率较低。许多因素会影响DVUI的治疗效果，包括狭窄部位、海绵体纤维化以及既往内镜下狭窄治疗情况。多次尿道切开术会对后续尿道成形术的成功率产生负面影响。因此，必须进行全面的术前诊断评估，包括逆行尿道造影/排尿性膀胱尿道造影（RUG/VCUG）和尿道膀胱镜检查，以便就狭窄复发风险和其他治疗选择向患者提供咨询。初次DVUI失败后，不能期望后续尿道切开术能治愈疾病。
