Zhou Shu-Kui, Zhang Jiong, Sa Ying-Long, Jin San-Bao, Xu Yue-Min, Fu Qiang, Lazzeri Massimo
Department of Urology, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
Urol Int. 2016;97(4):386-391. doi: 10.1159/000444592. Epub 2016 Jun 14.
To investigate the etiology and management of male iatrogenic urethral stricture in China.
The data of 172 patients with iatrogenic urethral stricture who underwent treatment at a high volume reference center in China from January 2008 to February 2014 were analyzed retrospectively. Databases were analyzed to understand the impact of different types of iatrogenic injury on stricture location, length and treatment of urethral strictures, as well as success rates.
The most common type of iatrogenic stricture was urethral instrumentations in 80 patients (46.51%). Mean stricture length was 3.3 ± 2.54 cm and the longest strictures were those caused by intravesical instillation. Substitution urethroplasty was the most common intervention and was performed in 60.47% (104/172) of patients. The overall success rate was 85.00% (136/160). Univariable analyses revealed that the type of iatrogenic injury was significantly related to restenosis (p = 0.036), and it is more apt to postoperative restenosis in the type of intravesical instillation than others.
Our results showed that urethral instrumentation is the most common etiology of iatrogenic urethral stricture, and most iatrogenic urethral strictures involve the anterior urethra. The different etiologies are closely associated with stricture location, length and the overall prognosis of urethral strictures.
探讨中国男性医源性尿道狭窄的病因及治疗方法。
回顾性分析2008年1月至2014年2月在中国一家大型参考中心接受治疗的172例医源性尿道狭窄患者的数据。分析数据库以了解不同类型医源性损伤对尿道狭窄部位、长度、治疗及成功率的影响。
最常见的医源性狭窄类型是尿道器械操作，共80例（46.51%）。平均狭窄长度为3.3±2.54 cm，最长的狭窄是由膀胱内灌注引起的。替代尿道成形术是最常见的干预措施，60.47%（104/172）的患者接受了该手术。总体成功率为85.00%（136/160）。单因素分析显示，医源性损伤类型与再狭窄显著相关（p = 0.036），膀胱内灌注类型比其他类型更容易发生术后再狭窄。
我们的结果表明，尿道器械操作是医源性尿道狭窄最常见的病因，大多数医源性尿道狭窄累及前尿道。不同病因与尿道狭窄的部位、长度及总体预后密切相关。
