Karsli Onur, Ustuner Murat, Memik Omur, Ulukaradag Emre
University of Health Sciences, Derince Training and Research Hospital, Department of Urology, Kocaeli, Turkey.
Urol J. 2020 Jan 26;17(1):68-72. doi: 10.22037/uj.v0i0.4662.
The most common option for the management of urethral stricture (US) is direct visual internal urethrotomy (DVIU), because it is an easy and minimally invasive technique but the low success and high recurrence rates of this technique make urologists research for different types of therapeutic alternatives in stricture treatment. In this study we aimed to compare the internal urethrotomy with amplatz dilation for the treatment of male US.
A total of sixty patients, who have been operated due to urethral stricture were enrolled into this study. Group 1 was treated with amplatz renal dilators and the group 2 was treated with cold knife urethrotomy. All patients were evaluated for Qmax preoperatively and at the first, 3rd, 9th and 12th months postoperatively.
In the 3 month uroflowmetry results, mean Q max values were 15.6±2 ml/sec in amplatz group and 15.5±1.6 ml/sec in DVIU group. There was no statisticaly difference between the two groups. However the Q max values in the postoperative 9 and 12 months were significantly decreased in the DVIU group. In the DVIU group 9 recurrences (36%) appeared and 2 of these reccurrences were in the first 3 months, whereas in the amplatz group no recurrences appeared in the first 3 months. The urethral stricture recurrence rate up to the 12 month follow up was statistically significant for group 1 when it is compared with group 2. Conclusions: In our experience, amplatz dilation is a good option as the initial treatment for urethral stricture.
尿道狭窄（US）治疗最常见的选择是直视下内尿道切开术（DVIU），因为它是一种简单且微创的技术，但该技术的低成功率和高复发率促使泌尿外科医生研究狭窄治疗的不同类型替代疗法。在本研究中，我们旨在比较内尿道切开术与Amplatz扩张术治疗男性尿道狭窄的效果。
本研究共纳入60例因尿道狭窄接受手术的患者。第1组采用Amplatz肾扩张器治疗，第2组采用冷刀尿道切开术治疗。所有患者在术前以及术后第1、3、9和12个月进行最大尿流率（Qmax）评估。
在术后3个月的尿流率结果中，Amplatz组的平均Qmax值为15.6±2 ml/秒，DVIU组为15.5±1.6 ml/秒。两组之间无统计学差异。然而，DVIU组术后9个月和12个月的Qmax值显著下降。DVIU组出现9例复发（36%），其中2例在术后前3个月复发，而Amplatz组在术后前3个月未出现复发。与第2组相比，第1组至12个月随访时的尿道狭窄复发率具有统计学意义。结论：根据我们的经验，Amplatz扩张术是尿道狭窄初始治疗的一个良好选择。
