Nicholson Helen L, Al-Hakeem Yasser, Maldonado Javier J, Tse Vincent
Department of Urology, Concord Repatriation General Hospital, Concord, University of Sydney, Australia.
Department of Urology, Macquarie University Hospital, Sydney, Australia.
Transl Androl Urol. 2017 Jul;6(Suppl 2):S92-S102. doi: 10.21037/tau.2017.04.33.
The aim of this review is to examine all urethral strictures and stenoses subsequent to treatment for prostate cancer, including radical prostatectomy (RP), radiotherapy, high intensity focused ultrasound (HIFU) and cryotherapy. The overall majority respond to endoscopic treatment, including dilatation, direct visual internal urethrotomy (DVIU) or bladder neck incision (BNI). There are adjunct treatments to endoscopic management, including injections of corticosteroids and mitomycin C (MMC) and urethral stents, which remain controversial and are not currently mainstay of treatment. Recalcitrant strictures are most commonly managed with urethroplasty, while recalcitrant stenosis is relatively rare yet almost always associated with bothersome urinary incontinence, requiring bladder neck reconstruction and subsequent artificial urinary sphincter (AUS) implantation, or urinary diversion for the devastated outlet.
本综述的目的是研究前列腺癌治疗后出现的所有尿道狭窄和狭窄，包括根治性前列腺切除术（RP）、放射治疗、高强度聚焦超声（HIFU）和冷冻治疗。总体而言，大多数患者对内镜治疗有反应，包括扩张、直视下内尿道切开术（DVIU）或膀胱颈切开术（BNI）。内镜治疗有辅助治疗方法，包括注射皮质类固醇和丝裂霉素C（MMC）以及尿道支架，但这些方法仍存在争议，目前并非主要治疗手段。顽固性狭窄最常见的治疗方法是尿道成形术，而顽固性狭窄相对少见，但几乎总是与令人烦恼的尿失禁相关，需要进行膀胱颈重建及随后植入人工尿道括约肌（AUS），或对严重受损的尿道进行尿路改道。
