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经会阴一期入路行背侧颊黏膜移植尿道成形术治疗长段尿道狭窄

Dorsally Placed Buccal Mucosal Graft Urethroplasty in Treatment of Long Urethral Strictures Using One-Stage Transperineal Approach.

作者信息

Tavakkoli Tabassi Kamyar, Ghoreifi Alireza

机构信息

Urology Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad Center for Reconstructive Urology and Plastic Surgery of External Genitalia, P.O. Box 9137913316, Iran.

出版信息

Int Sch Res Notices. 2014 Jul 6;2014:792982. doi: 10.1155/2014/792982. eCollection 2014.

Abstract

Objectives. To evaluate the results of one-stage buccal mucosal urethroplasty in treatment of long urethral strictures. Methods. This retrospective study was carried out on 117 patients with long urethral strictures who underwent one-stage transperineal urethroplasty with dorsally placed buccal mucosal grafts (BMG). Success was defined as no need for any intervention during the follow-up period. Results. Among 117 patients with mean age of 39.55 ± 15.98 years, the strictures were located in penile urethra in 46 patients (39.32%), bulbar urethra in 33 (28.20%) and were panurethral in 38 (32.48%). The etiology of the urethral stricture was sexually transmitted disease (STD) in 17 (14.53%), lichen sclerosus in 15 (12.82%), trauma in 15 (12.82%), catheterization in 13 (11.11%), transurethral resection (TUR) in 6 (5.13%), and unknown in 51 (43.59%). The mean length of strictures was 9.31 ± 2.46 centimeters. During the mean followup of 18.9 ± 6.7 months success rate was 93.94% in bulbar strictures, 97.83% in penile strictures, and 84.21% in panurethral strictures (P value: 0.061). Conclusions. The success rate of transperineal urethroplasty with dorsally placed buccal mucosal grafts is equal in different sites of strictures with different etiologies. So reconstruction of long urethral strictures may be safely and effectively performed at a simple single operative procedure using this method of urethroplasty.

摘要

目的。评估一期颊黏膜尿道成形术治疗长段尿道狭窄的效果。方法。对117例长段尿道狭窄患者进行回顾性研究,这些患者接受了一期经会阴尿道成形术,并采用背侧放置的颊黏膜移植物(BMG)。成功定义为随访期间无需任何干预。结果。117例患者平均年龄为39.55±15.98岁,其中46例(39.32%)狭窄位于阴茎尿道,33例(28.20%)位于球部尿道,38例(32.48%)为全尿道狭窄。尿道狭窄的病因包括性传播疾病(STD)17例(14.53%)、硬化性苔藓15例(12.82%)、外伤15例(12.82%)、导尿13例(11.11%)、经尿道切除术(TUR)6例(5.13%),51例(43.59%)病因不明。狭窄的平均长度为9.31±2.46厘米。在平均18.9±6.7个月的随访中,球部狭窄的成功率为93.94%,阴茎狭窄为97.83%,全尿道狭窄为84.21%(P值:0.061)。结论。采用背侧放置颊黏膜移植物的经会阴尿道成形术在不同病因、不同部位狭窄中的成功率相当。因此,使用这种尿道成形术方法,可通过简单的单一手术安全有效地进行长段尿道狭窄的重建。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed6b/4897145/298f9f0dcc4d/ISRN2014-792982.001.jpg

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