Abdelhameed Hussein, Elgamal Samir, Farha Mohamed A, El-Abd Ahmed, Tawfik Ahmed, Soliman Mohamed
Fayoum Faculty of Medicine, Fayoum, Egypt.
Tanta Faculty of Medicine, Tanta, Egypt.
Arab J Urol. 2015 Jun;13(2):128-33. doi: 10.1016/j.aju.2014.11.009. Epub 2015 Feb 7.
To evaluate the long-term results of repairing long anterior urethral strictures with lingual mucosa onlay grafts.
This study included 23 patients (mean age 36.3 years, range 21-62) who had a lingual mucosa onlay graft for managing a long anterior urethral stricture, and who were followed up for ⩾5 years. The mean length of the stricture was 4.6 cm. The International Prostate Symptom Score and uroflowmetry values were obtained before surgery, and at 3, 6 and 12 months afterwards, and annually thereafter. A retrograde urethrogram with a voiding cysto-urethrogram was taken before surgery, at catheter removal, after 3 and 6 months, and selectively thereafter.
The mean (range) follow-up was 66 (60-72) months. The cause of the stricture was trauma in nine patients, instrumentation in seven, idiopathic in four, urethritis in two and previous hypospadias repair in one. The surgery was successful in 20 of the 23 patients (87%), and a recurrent stricture developed in the remaining three. There were no fistulae or clinically perceptible graft sacculations, and no long-term donor-site complications.
With a long-term follow-up, our series confirms the durability of lingual mucosal onlay grafts for treating long anterior urethral strictures. This procedure results in a long-term high success rate with few of the complications that occur primarily during the first year.
评估采用舌黏膜覆盖移植修复前尿道长段狭窄的远期效果。
本研究纳入了23例患者（平均年龄36.3岁，范围21 - 62岁），这些患者接受了舌黏膜覆盖移植以处理前尿道长段狭窄，并进行了至少5年的随访。狭窄的平均长度为4.6厘米。在手术前、术后3个月、6个月和12个月以及此后每年获取国际前列腺症状评分和尿流率值。在手术前、拔除导尿管时、术后3个月和6个月以及之后选择性地进行逆行尿道造影及排尿期膀胱尿道造影。
平均（范围）随访时间为66（60 - 72）个月。狭窄的原因包括9例创伤、7例器械操作、4例特发性、2例尿道炎和1例既往尿道下裂修复。23例患者中有20例（87%）手术成功，其余3例出现复发性狭窄。未出现瘘管或临床上可察觉的移植片袋状扩张，且无长期供区并发症。
通过长期随访，我们的系列研究证实了舌黏膜覆盖移植治疗前尿道长段狭窄的持久性。该手术长期成功率高，且主要在第一年出现的并发症较少。
