Ali Ahmed Issam, Hamid Amr Abdel, Abdel-Rassoul Mohammed Abdou, Galal Ehab M, Hasanein Mohammed G S, Hassan Mohamed Abd Elmalek, El-Hawy Mamdouh M
Minia University Hospital, School of Medicine, Department of Urology, Minia, Egypt.
Minia University, School of Medicine, Department of Urology, Minia, Egypt.
Cent European J Urol. 2019;72(2):191-197. doi: 10.5173/ceju.2019.1899. Epub 2019 Jun 29.
The aim of this study was to analyze the outcomes of dorsolateral onlay buccal mucosal graft (BMG) and ventral onlay local penile skin flap (LPF) urethroplasty in the management of long segment penile urethral stricture (PUS).
Through a prospective study conducted between October 2014 and May 2018, 84 patients with long segment PUS were randomly assigned to receive either dorsolateral onlay BMG (Group 1 which included 42 patients) or ventral onlay PSF urethroplasty (Group 2 which included 42 patients). The success rate and surgical outcomes were compared in both groups.
The success rate was 92.9% in Group 1 and 85.7% in Group 2 (p = 0.5). Postoperative short segment urethral stricture at the site of proximal anastomosis was reported in 3 patients in Group 1. Six patients in Group 2 were considered as a treatment failure, 3 of them due to recurrence of long segment urethral stricture after 6 months, and 3 patients developed ring urethral stricture at the site of proximal anastomosis managed by direct vision internal urethrotomy.
On an intermediate term follow-up, dorsolateral onlay BMG and ventral onlay LPF provide similar success rates in penile urethroplasty, with essentially comparable postoperative morbidity. However, further studies with bigger sample sizes and longer follow-up periods may be required to determine subtle differences between both techniques.
本研究的目的是分析背外侧嵌贴式颊黏膜移植（BMG）和腹侧嵌贴式局部阴茎皮瓣（LPF）尿道成形术治疗长段阴茎尿道狭窄（PUS）的效果。
通过一项于2014年10月至2018年5月进行的前瞻性研究，84例长段PUS患者被随机分配接受背外侧嵌贴式BMG（第1组，包括42例患者）或腹侧嵌贴式LPF尿道成形术（第2组，包括42例患者）。比较两组的成功率和手术效果。
第1组的成功率为92.9%，第2组为85.7%（p = 0.5）。第1组有3例患者术后在近端吻合口处出现短段尿道狭窄。第2组有6例患者被视为治疗失败，其中3例是由于6个月后长段尿道狭窄复发，3例患者在近端吻合口处出现环状尿道狭窄，需通过直视下尿道内切开术处理。
在中期随访中，背外侧嵌贴式BMG和腹侧嵌贴式LPF在阴茎尿道成形术中的成功率相似，术后发病率基本相当。然而，可能需要进一步开展样本量更大、随访期更长的研究来确定两种技术之间的细微差异。
