Xie Linhai, Li Senkai, Li Qiang
Hypospadias Treatment Center, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Urol Int. 2013;91(3):256-60. doi: 10.1159/000353101. Epub 2013 Aug 14.
To evaluate technical aspects and outcome of preventing urethrocutaneous fistula and calculi recurrence in surgical treatment of urethral calculi associated with hairballs after urethroplasty.
Sixteen patients who had urethral calculi associated with hairballs after urethroplasty underwent urethrolithotomy and trimming and epilation of the neourethra. While operating, we made a staggered incision of the skin and urethra, carefully sutured the urethral incision, and covered it by well-vascularized tissue. A tube-in-tube stent method was performed on the latter 12 patients for better drainage of the exudates that accumulated in the urethra.
All calculi were successfully removed. Surgical site infection occurred in the last one of the former 4 patients and resulted in an urethrocutaneous fistula. There were no other complications. All patients were followed up for 2-7 years; no urethral stenosis or recurrence of calculi was observed, and remarkable reduction of urethral hair was obtained.
Urethrolithotomy and trimming and epilation of the neourethra seem to be appropriate treatments for urethral calculi associated with hairballs after urethroplasty. Full attention should be paid to fistula prevention.
评估尿道成形术后尿道结石合并毛球手术治疗中预防尿道皮肤瘘和结石复发的技术要点及治疗效果。
16例尿道成形术后尿道结石合并毛球患者接受了尿道切开取石术及新尿道修整和脱毛术。手术时，我们对皮肤和尿道做了交错切口，仔细缝合尿道切口，并用血运良好的组织覆盖。后12例患者采用双管支架法，以更好地引流尿道内积聚的渗出物。
所有结石均成功取出。前4例患者中的最后1例发生手术部位感染并导致尿道皮肤瘘。无其他并发症。所有患者随访2至7年；未观察到尿道狭窄或结石复发，尿道毛发明显减少。
尿道切开取石术及新尿道修整和脱毛术似乎是尿道成形术后尿道结石合并毛球的合适治疗方法。应充分重视瘘的预防。
