Division of Urology, Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria.
Niger J Clin Pract. 2021 Jan;24(1):45-50. doi: 10.4103/njcp.njcp_74_20.
Currently, transperineal anastomotic urethroplasty approach is the reference standard in the surgical reconstruction of pelvic fracture urethral distraction defects. The approach is suitable for all but the most complex cases which might require abdominoperineal approach.
We reviewed our recent experience with transperineal anastomotic urethroplasty with respect to success rate and complications.
This was a retrospective descriptive study carried out at Jos University Teaching Hospital from March 2015 to March 2018. The case notes of male patients who had transperineal anastomotic urethroplasty for pelvic fracture urethral distraction defects within the study period were retrieved. Patients' demographics, cause and nature of pelvic fracture urethral distraction defects, the success rate, and complications were collected and subjected to statistical analysis using SPSS version 22.
Sixteen men with mean age of 29.6 ± 7.8 years had transperineal anastomotic urethroplasty for pelvic fracture urethral distraction defect (PFUDD) during the study period. The mean defect gap length was 4.5 cm (range, 2-7 cm). Out of the 16 patients, 6 (37.5%) had simple transperineal urethroplasty, while 10 (62.5%) underwent a more extensive transperineal urethroplasty. Four patients (25%) had inferior pubectomy. A total of 7 (43.8%) patients had erectile dysfunction (ED) before and after the urethroplasty. Five (31.3%) patients had ED before the urethroplasty 2 (12.5%) patients developed ED after the surgery. After mean follow-up duration of 2 years (range, 1-4 years), 12 (75%) patients had satisfactory urinary stream. The mean Qmax for the 16 patients was 16 ml/s (range, 0-35 ml/s). The 12 (75%) patients that had no complaints of LUTS, had Qmax ≥ 15 ml/s at mean follow-up duration of 2 years.
Transperineal anastomotic urethroplasty for PFUDD is considered suitable technique for treatment of PFUDD with good surgical outcome.
目前，经会阴吻合尿道成形术是骨盆骨折尿道牵拉伤的手术重建的参考标准。该方法适用于除最复杂病例以外的所有病例，而最复杂的病例可能需要采用经腹会阴入路。
我们回顾了经会阴吻合尿道成形术的近期经验，包括成功率和并发症。
这是一项回顾性描述性研究，于 2015 年 3 月至 2018 年 3 月在乔斯大学教学医院进行。检索了在此期间接受经会阴吻合尿道成形术治疗骨盆骨折尿道牵拉伤的男性患者的病历。收集了患者的人口统计学资料、骨盆骨折尿道牵拉伤的病因和性质、成功率和并发症，并使用 SPSS 版本 22 进行了统计分析。
16 名男性患者的平均年龄为 29.6 ± 7.8 岁，因骨盆骨折尿道牵拉伤接受经会阴吻合尿道成形术（PFUDD）治疗。平均缺损间隙长度为 4.5cm（范围 2-7cm）。16 例患者中，6 例（37.5%）接受简单的经会阴尿道成形术，10 例（62.5%）接受更广泛的经会阴尿道成形术。4 例（25%）行耻骨下切除术。术前有 7 例（43.8%）患者存在勃起功能障碍（ED），术后有 12 例（75%）患者出现 ED。术前有 5 例（31.3%）患者存在 ED，术后有 2 例（12.5%）患者出现 ED。术后平均随访 2 年（范围 1-4 年），12 例（75%）患者的尿流满意。16 例患者的平均最大尿流率（Qmax）为 16ml/s（范围 0-35ml/s）。12 例（75%）无下尿路症状（LUTS）且 Qmax≥15ml/s的患者，在术后 2 年的平均随访时间内无 LUTS 症状。
经会阴吻合尿道成形术治疗骨盆骨折尿道牵拉伤是一种治疗效果良好的手术方法。
