Enganti Bhavatej, Reddy Mannem Srinath, Chiruvella Mallikarjuna, Bendigeri Mohammed Taif, Ragoori Deepak, Ghouse Syed Mohammed, Reddy Purnachandra
Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad, India.
Turk J Urol. 2020 Sep;46(5):383-387. doi: 10.5152/tud.2020.20106. Epub 2020 Jun 1.
To present our initial experience with double-face augmentation urethroplasty for near-obliterative bulbar urethral strictures and analyze the short-term outcomes.
We retrospectively evaluated a prospectively maintained database of patients with near-obliterative bulbar urethral strictures (>2 cm), who underwent double-face augmentation urethroplasty. The patients' demographic characteristics, clinical data, and data regarding the investigations conducted were analyzed. Near-obliterative urethral stricture was defined as lumen <6 Fr. Double-face urethroplasty was performed using a ventral approach, during which dorsal inlay and ventral onlay buccal mucosal graft (BMG) augmentation were performed. A successful outcome was defined as normal voiding without the need for any instrumentation to improve the urinary flow rate.
A total of 37 patients with a mean age of 50±11.7 years, who underwent this procedure were included in the study. The mean stricture length was 5.2±0.95 cm. The mean length of the dorsal inlay BMG augmentation was 3.1±0.5 cm and that of the ventral onlay BMG augmentation was 6.3±1.2 cm. Post-void dribbling (18.9%) was the most commonly reported complication. The maximum flow rates and symptom scores significantly improved in both groups compared with the preoperative parameters (p<0.001). The incidence of both erectile dysfunction and ejaculatory failure was reported in 6 (16.2%) patients; respectively. The overall success rate was 86.5% at a median follow-up period of 36 months (IQR: 26.5-43).
Double-face augmentation urethroplasty is a safe and feasible option for near-obliterative bulbar urethral strictures, and our study showed satisfactory short-term outcomes for the same.
介绍我们采用双面增强尿道成形术治疗近闭塞性球部尿道狭窄的初步经验，并分析短期疗效。
我们回顾性评估了一个前瞻性维护的近闭塞性球部尿道狭窄（>2 cm）患者数据库，这些患者接受了双面增强尿道成形术。分析了患者的人口统计学特征、临床数据以及相关检查数据。近闭塞性尿道狭窄定义为管腔<6 Fr。采用腹侧入路进行双面尿道成形术，术中进行背侧镶嵌和腹侧覆盖颊黏膜移植（BMG）增强。成功结局定义为排尿正常，无需任何器械辅助来改善尿流率。
本研究共纳入37例平均年龄为50±11.7岁且接受该手术的患者。平均狭窄长度为5.2±0.95 cm。背侧镶嵌BMG增强的平均长度为3.1±0.5 cm，腹侧覆盖BMG增强的平均长度为6.3±1.2 cm。术后滴沥（18.9%）是最常报告的并发症。与术前参数相比，两组的最大尿流率和症状评分均显著改善（p<0.001）。分别有6例（16.2%）患者报告了勃起功能障碍和射精失败的发生率。在中位随访期36个月（IQR：26.5 - 43）时，总体成功率为86.5%。
双面增强尿道成形术是治疗近闭塞性球部尿道狭窄的一种安全可行的选择，我们的研究显示了该手术令人满意的短期疗效。
