Okorie Chukwudi Ogonnaya
Department of Surgery, Banso Baptist Hospital, Kumbo, Cameroon ; Department of Surgery, Tenwek Hospital, Bomet, Kenya.
Nephrourol Mon. 2013 Sep;5(4):866-9. doi: 10.5812/numonthly.11012. Epub 2013 Jul 23.
Most contemporary series on urethral prolapse report either on the use of excisional or conservative treatment approaches.
To introduce a modified ligation over a Foley catheter treatment method for urethral prolapse that addresses most of the previously reported complications.
Five consecutive patients with urethral prolapse treated between 2003 and 2011, all using the ligation method on an outpatient basis were studied prospectively. Maintaining the inflated balloon of the Foley catheter with timed removal of the catheters among other modifications to the original technique is further described in the article. The main outcome measures were to evaluate for recurrence, post-operative appearance of the urethral orifice and satisfaction of parents. Secondarily the actions of the parents of the patients and those of the receiving physicians were also recorded.
The mean age of the patients was 6 years old (ranging from 3 to 8 years). All parents suspected sexual molestation and in two cases, the suspected perpetrators were verbally threatened of dire consequences of their actions if proven. None of the receiving medical personnel were aware of this condition. Maximum length of catheterization was for 4 days. The post treatment urethral openings appeared normal and there were no complications.
The ligation method with attention to the modifications described further in the article is a simple, safe and cost effective option for the management of urethral prolapse. Maintaining the inflated balloon of the Foley catheter with timed catheter removal especially adds predictability to this technique.
大多数关于尿道脱垂的当代系列报道要么是关于切除治疗方法，要么是保守治疗方法。
介绍一种经Foley导尿管改良结扎治疗尿道脱垂的方法，该方法可解决大多数先前报道的并发症。
对2003年至2011年间连续治疗的5例尿道脱垂患者进行前瞻性研究，所有患者均在门诊采用结扎方法。文章进一步描述了在维持Foley导尿管球囊充气的同时定时拔除导尿管以及对原始技术的其他改良。主要观察指标是评估复发情况、尿道口术后外观以及家长满意度。其次还记录了患者家长和接诊医生的行为。
患者平均年龄为6岁（3至8岁）。所有家长均怀疑有性侵犯行为，其中2例对疑似犯罪者口头威胁，称若被证实将承担其行为的严重后果。所有接诊医务人员均未意识到这种情况。导尿管留置最长时间为4天。治疗后尿道口外观正常，无并发症发生。
本文所述改良的结扎方法是一种治疗尿道脱垂简单、安全且经济有效的选择。维持Foley导尿管球囊充气并定时拔除导尿管尤其增加了该技术的可预测性。
