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全尿道狭窄修复术:颊黏膜移植尿道成形术的近端腹侧和远端背侧覆盖技术

Repair of panurethral stricture: Proximal ventral and distal dorsal onlay technique of buccal mucosal graft urethroplasty.

作者信息

Chodisetti Subbarao, Boddepalli Yogesh, Kota Malakondareddy

机构信息

Department of Urology, Andhra Medical College, Andhra Pradesh, India.

出版信息

Arab J Urol. 2017 Dec 26;16(2):211-216. doi: 10.1016/j.aju.2017.11.007. eCollection 2018 Jun.

Abstract

OBJECTIVE

To report the surgical details and results of our technique of buccal mucosal graft (BMG) urethroplasty for panurethral stricture, as many studies have reported repair of panurethral stricture by single-stage BMG urethroplasty by placing buccal mucosa ventrally, dorsally or dorsolaterally.

PATIENTS AND METHODS

This was an observational analysis of 38 patients with panurethral stricture treated by placing two BMGs, one as a ventral onlay in the proximal bulbar urethra and the other as a dorsal onlay in the distal bulbar and penile urethra. Success was defined as asymptomatic state with or without need for a postoperative single intervention such as dilatation or internal urethrotomy.

RESULTS

The 38 patients had a mean age of 44 years, with lichen sclerosus as the predominant cause of stricture. The ultimate success rate was 84.2% at the end of 3 months and 89.5% at the end of 1 year. Recurrent strictures appeared only in the failed cases during the follow-up period of 11 months. None of the patients needed redo urethroplasty during the follow-up period.

CONCLUSIONS

A proximal ventral and distal dorsal onlay technique of BMG urethroplasty is an available alternative for repairing panurethral stricture. The technique described is simple and easily reproducible with encouraging results compared to other similar techniques.

摘要

目的

许多研究报道了通过在腹侧、背侧或背外侧放置颊黏膜进行一期颊黏膜移植(BMG)尿道成形术修复全尿道狭窄,本文旨在报告我们采用BMG尿道成形术治疗全尿道狭窄的手术细节及结果。

患者与方法

这是一项对38例全尿道狭窄患者的观察性分析,采用放置两片BMG的方法进行治疗,一片作为腹侧补片置于球部尿道近端,另一片作为背侧补片置于球部尿道远端及阴茎尿道。成功定义为无症状状态,无论是否需要术后单次干预,如扩张或内尿道切开术。

结果

38例患者的平均年龄为44岁,主要病因是硬化性苔藓。3个月时的最终成功率为84.2%,1年时为89.5%。复发性狭窄仅出现在随访11个月期间的失败病例中。随访期间无患者需要再次进行尿道成形术。

结论

BMG尿道成形术近端腹侧和远端背侧补片技术是修复全尿道狭窄的一种可行替代方法。与其他类似技术相比,所描述的技术简单且易于重复,结果令人鼓舞。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cfd/5992266/91dede562c91/gr1.jpg

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