Mukhtar Bashir M B, Spilotros Marco, Malde Sachin, Greenwell Tamsin J
Department of Urology, University College London Hospital at Westmoreland Street, London, UK.
BJU Int. 2017 Nov;120(5):710-716. doi: 10.1111/bju.13970. Epub 2017 Aug 20.
To present our outcomes of ventral-onlay buccal mucosa graft (BMG) substitution urethroplasty in treating female urethral stricture (FUS).
We conducted a review of a prospectively collected database of 22 consecutive women (median [range] age 50 [34-72] years) with urethral stricture who underwent ventral onlay BMG substitution urethroplasty after June 2012 and who had a minimum follow-up of 6 months (median 21.5, range 6-51 months). Data were analysed for stricture recurrence, change in median maximum urinary flow rate (Q ) and median post-void residual urine volume (PVR). Statistical analysis was performed using the Wilcoxon signed rank test, Student's t-test and the Mann-Whitney U-test.
Freedom from stricture recurrence was achieved in 21/22 (95.5%) women. The median (range) Q significantly improved, increasing from 7 (3.5-11) to 18 (5-37) mL/s (P <0.05). The median (range) PVR was significantly reduced from 100 (0-300) to 15 (0-150) mL (P < 0.05). Short- and longer-term complication rates were low. One woman developed mild de novo stress urinary incontinence, which settled with conservative management by 6 months.
Early and medium-term results indicate that ventral onlay BMG substitution urethroplasty is an excellent treatment for FUS that can avoid the need for the repeat procedures regularly required after traditional endoscopic management.
介绍我们采用腹侧覆盖颊黏膜移植（BMG）替代尿道成形术治疗女性尿道狭窄（FUS）的结果。
我们回顾了一个前瞻性收集的数据库，该数据库包含22例连续的尿道狭窄女性患者（年龄中位数[范围]为50[34 - 72]岁），她们于2012年6月后接受了腹侧覆盖BMG替代尿道成形术，且至少随访6个月（中位数为21.5个月，范围为6 - 51个月）。分析了狭窄复发情况、最大尿流率中位数（Q）变化以及排尿后残余尿量中位数（PVR）。使用Wilcoxon符号秩检验、Student's t检验和Mann-Whitney U检验进行统计分析。
22例女性中有21例（95.5%）无狭窄复发。Q的中位数（范围）显著改善，从7（3.5 - 11）ml/s增加到18（5 - 37）ml/s（P < 0.05）。PVR的中位数（范围）从100（0 - 300）ml显著降至15（0 - 150）ml（P < 0.05）。短期和长期并发症发生率较低。1例女性出现轻度新发压力性尿失禁，6个月时通过保守治疗得到缓解。
早期和中期结果表明，腹侧覆盖BMG替代尿道成形术是治疗FUS的一种极佳方法，可避免传统内镜治疗后经常需要的重复手术。
