Schreiter F, Noll F
Department of Urology, University of Witten-Herdecke, Schwelm, Federal Republic of Germany.
J Urol. 1989 Nov;142(5):1223-6. doi: 10.1016/s0022-5347(17)39036-5.
Long urethral strictures remain one of the hazards of modern urology. Reconstructive operations with scrotal skin suffer a high rate of recurrent stricture. To avoid complications, meshed split thickness skin graft or foreskin was used to construct a neourethra. In stage 1 split thickness skin graft is harvested and transplanted along the opened urethra. In stage 2 the neourethra is formed 8 to 12 weeks later. Since 1977 mesh graft urethroplasty has been performed in 96 patients using meshed foreskin (76) or split thickness skin grafts (23). In all but 1 patient excellent anatomical and functional results were achieved regardless of which type of graft was used. This technique was most useful in exceedingly long or problematic strictures, for example in spinal cord injury patients.
长段尿道狭窄仍然是现代泌尿外科的难题之一。采用阴囊皮肤进行重建手术时,尿道狭窄复发率很高。为避免并发症,采用网状中厚皮片或包皮来构建新尿道。第一阶段,切取中厚皮片并沿开放的尿道进行移植。第二阶段,在8至12周后形成新尿道。自1977年以来,已对96例患者实施了网状移植尿道成形术,其中使用网状包皮的有76例,使用中厚皮片的有23例。除1例患者外,无论使用哪种类型的移植物,均取得了优异的解剖和功能效果。该技术在治疗极长或疑难性狭窄方面最为有用,例如在脊髓损伤患者中。