Kallidonis Panagiotis, Adamou Constantinos, Koutava Adamantia, Ntasiotis Panteleimon, Kotsiris Dimitrios, Al-Aown Abdulrahman, Liatsikos Evangelos
Department of Urology, University of Patras, Patras, Greece.
Department of Urology, Armed Forces Hospital Southern Region, Khamis Mushait, Kingdom of Saudi Arabia.
Urol Ann. 2018 Oct-Dec;10(4):375-379. doi: 10.4103/UA.UA_68_18.
Urethral strictures can be treated by urethral dilation, optical internal urethrotomy, or open surgical reconstruction (urethroplasty). Urethral dilation is done with filiforms and followers, balloons, or coaxial dilators inserted over a guidewire. The S-curved coaxial dilator (SCCD) was designed to facilitate the passage of the dilator through the stricture and the urethra because it imitates the curved anatomy of the male urethra. This study presents our experience with SCCD.
We used this kind of dilation in 310 patients. The technique included the insertion of a hydrophilic floppy-tipped guidewire through the urethra directly into the bladder under fluoroscopic control. The SCCDs were then inserted over the guidewire. Dilators of gradually increased size from 8F to 20F were used. The follow-up of the patients includes uroflowmetry and measurement of postvoid residual at 4 weeks, 6 months, or in the case of a recurrence of symptoms.
The age of the patients were 69.08 ± 15.77 years. The causes of urethral stricture were iatrogenic ( = 114), traumatic ( = 35), infectious ( = 22), and of unknown origin ( = 139). The stricture length was 1.62 ± 0.85 cm. The mean number of dilations needed per case was 2 (range: 1-15), and the time between the dilations was 212.19 ± 253.9 days. We had seven failures.
We propose the S-curved coaxial dilators for urethral dilation as a safe and effective technique because of their similarity to the shape of the male urethra and because of their hydrophilic coating.
尿道狭窄可通过尿道扩张、直视下尿道内切开术或开放性手术重建（尿道成形术）进行治疗。尿道扩张采用丝状探子和导子、球囊或经导丝插入的同轴扩张器来完成。S形同轴扩张器（SCCD）的设计是为了便于扩张器穿过狭窄段和尿道，因为它模仿了男性尿道的弯曲解剖结构。本研究介绍了我们使用SCCD的经验。
我们对310例患者采用了这种扩张方法。该技术包括在荧光透视控制下，将一根亲水软头导丝经尿道直接插入膀胱。然后将SCCD经导丝插入。使用从8F到20F逐渐增大尺寸的扩张器。对患者的随访包括在4周、6个月时或出现症状复发时进行尿流率测定和排尿后残余尿量测量。
患者年龄为69.08±15.77岁。尿道狭窄的原因包括医源性（n = 114）、外伤性（n = 35）、感染性（n = 22）和原因不明（n = 139）。狭窄长度为1.62±0.85 cm。每例患者所需扩张的平均次数为2次（范围：1 - 15次），扩张之间的时间间隔为212.19±253.9天。我们有7例失败病例。
我们建议将S形同轴扩张器用于尿道扩张，因为它们与男性尿道形状相似且具有亲水涂层，是一种安全有效的技术。
