Shaw Nathan M, Venkatesan Krishnan
Department of Urology, Georgetown University Hospital, 3800 Reservoir Rd NW, PHC 1, Washington, DC, 20037, USA.
Department of Urology, Medstar Washington Hospital Center, 110 Irving St NW, Suite 3B-19, Washington, DC, 20010, USA.
Curr Urol Rep. 2018 Feb 26;19(3):19. doi: 10.1007/s11934-018-0771-6.
Male urethral stricture disease is characterized by the formation of scar tissue within the urethra resulting in lower urinary tract symptoms, infection, and potentially kidney dysfunction. There is significant variability in clinical practice for the treatment of urethral stricture. We sought to summarize the known data on endoscopic management of urethral stricture disease as part of this larger edition on urethral stricture management.
Older studies quoted high rates of success with endoscopic management of urethral stricture, including repeated DVIU. There is now evidence to support a limited role of endoscopic intervention in the management of urethral stricture, and especially strong evidence that repeated endoscopic procedures are not effective. There is poor evidence to support the long-term efficacy of endoscopic urethral stricture management. Furthermore, novel advances in adjunctive therapies have not yet demonstrated durable patency. We discuss the limited role of endoscopic management and suggest an algorithm for its use in stricture management.
男性尿道狭窄疾病的特征是尿道内形成瘢痕组织，导致下尿路症状、感染，并可能引发肾功能障碍。在尿道狭窄的治疗方面，临床实践存在显著差异。作为关于尿道狭窄管理的这一较大版本的一部分，我们试图总结有关尿道狭窄疾病内镜治疗的已知数据。
早期研究表明内镜治疗尿道狭窄，包括重复的经尿道内切开术（DVIU）成功率很高。现在有证据支持内镜干预在尿道狭窄管理中的作用有限，尤其是有强有力的证据表明重复内镜手术无效。几乎没有证据支持内镜治疗尿道狭窄的长期疗效。此外，辅助治疗的新进展尚未证明能实现持久的通畅。我们讨论了内镜治疗的有限作用，并提出了其在狭窄管理中的应用算法。
