Rosenbaum Clemens M, Reiss C Philip, Borgmann Hendrik, Salem Johannes, Fisch Margit, Huber Johannes, Schmid Marianne, Ahyai Sascha A
Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Urol Int. 2017;99(1):43-50. doi: 10.1159/000471928. Epub 2017 Jun 10.
Treatment methods of anterior urethral strictures in adults have undergone considerable changes in the recent past. Our goal was to determine national practice patterns among German urologists and to compare results with the results of prior international surveys.
We conducted a survey on the management of urethral strictures among German urologists.
Eight hundred forty-five urologists, representing about 14.6% of German urologists, answered the survey. Most common procedures were direct vision internal urethrotomy (DVIU; 87.2%), blind internal urethrotomy (57.5%), dilatation (56.3%), ventral buccal mucosa graft urethroplasty (31.6%) and excision and primary anastomosis (28.9%). In case of a 3.5-cm bulbar stricture and in the case of a 1-cm bulbar stricture after 2 failed DVIUs, a consecutive urethroplasty was significantly more often favoured compared to transurethral treatment options (44.9 vs. 21.3% and 59.4 vs. 8.3%, both p < 0.001).
Open urethral reconstruction reveals to be a more common method in practice nowadays. Adherence to recommended treatment algorithms improved in comparison to prior surveys.
近年来,成人前尿道狭窄的治疗方法发生了显著变化。我们的目标是确定德国泌尿外科医生的全国实践模式,并将结果与先前国际调查的结果进行比较。
我们对德国泌尿外科医生进行了一项关于尿道狭窄管理的调查。
845名泌尿外科医生回复了调查,约占德国泌尿外科医生的14.6%。最常见的手术是直视下内尿道切开术(DVIU;87.2%)、盲目内尿道切开术(57.5%)、扩张术(56.3%)、腹侧颊黏膜移植尿道成形术(31.6%)和切除并一期吻合术(28.9%)。对于3.5厘米的球部狭窄以及2次DVIU失败后的1厘米球部狭窄,与经尿道治疗方案相比,连续尿道成形术明显更常被青睐(分别为44.9%对21.3%以及59.4%对8.3%,均p < 0.001)。
如今,开放尿道重建在实践中是一种更常见的方法。与先前的调查相比,对推荐治疗算法的遵循有所改善。