Department of Urology, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Department of Urology, Faculty of Medicine, Ain Shams University, Ain Shams, Egypt.
Int J Urol. 2020 Apr;27(4):320-325. doi: 10.1111/iju.14187. Epub 2020 Feb 8.
To evaluate the long-term outcomes of dorsal onlay urethroplasty using lingual mucosal graft for repairing urethral strictures associated with genital lichen sclerosis.
This study included 36 patients who had lichen sclerosis long anterior urethral strictures that were managed with dorsal onlay urethroplasty using lingual mucosal graft, and were followed up ≥5 years. Preoperatively, we measured the maximum urinary flow rate and the International Prostate Symptom Score, then every 3 months in the first year, and annually thereafter. During follow up, patients with obstructive symptoms were subjected to urethrography and/ or urethroscopy. A successful urethroplasty was defined as normal voiding and no need for further intervention.
Of the 36 patients, two were lost during the follow up, thus 34 patients were involved in the assessment. After lingual mucosal graft urethroplasty, there were significant improvements in maximum urinary flow rate and International Prostate Symptom Score (P < 0.0001). This improvement was sustained during the 5-year follow-up period. The median follow-up period was 66.5 months (interquartile range 64-70 months). The overall success rate in this study was 88.2%. Postoperative complications that required intervention were reported within the first year in four (11.8%) patients. Oral site complications were mild in the early postoperative period with no long-term complications.
Dorsal onlay urethroplasty using lingual mucosal graft is a reliable and durable procedure for repairing lichen sclerosis urethral stricture. It provides a long-term success rate with few failures occurring within the first year. Lingual mucosal graft harvesting is associated with minor, immediate oral complications, and no long-term morbidity.
评估采用舌黏膜移植物行背侧加层尿道成形术治疗与阴部硬化性苔藓相关的尿道狭窄的长期疗效。
本研究纳入了 36 例接受背侧加层尿道成形术治疗的阴部硬化性苔藓所致长段前尿道狭窄患者，均采用舌黏膜移植物，随访时间≥5 年。术前，我们测量了最大尿流率和国际前列腺症状评分，然后在第 1 年每 3 个月，此后每年进行一次。在随访期间，有梗阻症状的患者接受尿道造影和/或尿道镜检查。成功的尿道成形术定义为正常排尿，无需进一步干预。
36 例患者中有 2 例在随访过程中失访，因此有 34 例患者参与评估。行舌黏膜移植物尿道成形术后，最大尿流率和国际前列腺症状评分均有显著改善（P<0.0001）。这种改善在 5 年随访期间得以维持。中位随访时间为 66.5 个月（四分位距 64-70 个月）。本研究的总体成功率为 88.2%。4 例（11.8%）患者在术后 1 年内报告了需要干预的术后并发症。术后早期口腔部位并发症轻微，无长期并发症。
采用舌黏膜移植物行背侧加层尿道成形术治疗阴部硬化性苔藓所致尿道狭窄是一种可靠且持久的方法。它提供了长期成功率，且在术后 1 年内失败的情况很少。舌黏膜移植物采集相关的口腔并发症轻微且为即刻性，无长期发病率。
