Tinaut-Ranera Javier, Arrabal-Polo Miguel Ángel, Merino-Salas Sergio, Nogueras-Ocaña Mercedes, López-León Víctor Manuel, Palao-Yago Francisco, Arrabal-Martín Miguel, Lahoz-García Clara, Alaminos Miguel, Zuluaga-Gomez Armando
Urology Department, San Cecilio University Hospital, Granada, Spain;
Histology Department, Faculty of Medicine, Granada, Spain.
Can Urol Assoc J. 2014 Jan-Feb;8(1-2):E16-9. doi: 10.5489/cuaj.1407.
We analyze the outcomes of patients with urethral stricture who underwent surgical treatment within the past 5 years.
This is a retrospective study of male patients who underwent surgery for urethral stricture at our service from January 2008 to June 2012. We analyzed the comorbidities, type, length and location of the stricture and the surgical treatment outcome after endoscopic urethrotomy, urethroplasty or both.
In total, 45 patients with a mean age of 53.7 ± 16.7 years underwent surgical treatment for urethral stricture. Six months after surgery, 46.7% of the patients had a maximum urinary flow greater than 15 mL/s, whereas 87.3% of the patients exhibited no stricture by urethrography after the treatment. The success rate in the patients undergoing urethrotomy was 47.8% versus 86.4% in those undergoing urethroplasty (p = 0.01). Twenty percent of the patients in whom the initial urethrotomy had failed subsequently underwent urethroplasty, thereby increasing the treatment success.
In most cases, the treatment of choice for urethral stricture should be urethroplasty. Previous treatment with urethrotomy does not appear to produce adverse effects that affect the outcome of a urethroplasty if urethrotomy failed, so urethrotomy may be indicated in patients with short strictures or in patients at high surgical risk.
我们分析了过去5年内接受手术治疗的尿道狭窄患者的治疗结果。
这是一项对2008年1月至2012年6月在我院接受尿道狭窄手术的男性患者的回顾性研究。我们分析了患者的合并症、狭窄的类型、长度和位置，以及内镜下尿道切开术、尿道成形术或两者联合治疗后的手术治疗结果。
共有45例平均年龄为53.7±16.7岁的患者接受了尿道狭窄手术治疗。术后6个月，46.7%的患者最大尿流率大于15 mL/s，而87.3%的患者治疗后尿道造影显示无狭窄。接受尿道切开术的患者成功率为47.8%，而接受尿道成形术的患者成功率为86.4%（p = 0.01）。最初尿道切开术失败的患者中有20%随后接受了尿道成形术，从而提高了治疗成功率。
在大多数情况下，尿道狭窄的首选治疗方法应为尿道成形术。如果尿道切开术失败，先前的尿道切开术似乎不会产生影响尿道成形术结果的不良反应，因此尿道切开术可用于狭窄较短的患者或手术风险较高的患者。
