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复发性尿道狭窄的管理:一项治疗挑战。

Management of Recurrent Urethral Strictures: A Therapeutic Challenge.

作者信息

Iqbal Mashood, Khawaja Uzzam Ahmed

机构信息

Internal Medicine, Jinnah Medical College Hospital, Karachi, PAK.

Internal Medicine, Jinnah Medical and Dental College, Karachi, PAK.

出版信息

Cureus. 2020 Dec 24;12(12):e12253. doi: 10.7759/cureus.12253.

Abstract

Urethral stricture disease is relatively common, and its management remains a therapeutic challenge for urologists despite recent advancements in endoscopic and reconstructive surgery. The majority of the strictures are acquired from injury or infection. Urethral stent implantation, a minimally invasive procedure, can be safely and effectively used as a primary surgical procedure in treating recurrent urethral stricture. Herein, we present a case of a 43-year-old male patient with complaints of intermittent urination, oliguria, and incomplete voiding with urinary frequency. Further urological investigations, a uroflowmetry, and a urethrogram were carried out. Oliguria, along with a mid-bulbar urethral stricture at the previous excision anastomotic site, was diagnosed. Despite a higher success rate of urethroplasty and temporary stent placement, urethral stricture recurrences are still an occurring entity. No definite therapeutic strategy has been adopted to evaluate and approach the morbidity effectively. Implementation of an effective primary procedure with minimally based complications should be generated to avoid future stricture recurrences. Larger-scale studies involving urethral stricture patients can gather sufficient data to obtain a complete curative treatment option for the future.

摘要

尿道狭窄疾病相对常见,尽管内镜和重建手术最近取得了进展,但其治疗仍然是泌尿外科医生面临的一项治疗挑战。大多数狭窄是由损伤或感染引起的。尿道支架植入是一种微创手术,可安全有效地用作治疗复发性尿道狭窄的主要外科手术。在此,我们报告一例43岁男性患者,主诉间歇性排尿、少尿以及尿频伴排尿不完全。进一步进行了泌尿外科检查、尿流率测定和尿道造影。诊断为少尿,同时在前次切除吻合部位存在球部中段尿道狭窄。尽管尿道成形术和临时支架置入的成功率较高,但尿道狭窄复发仍然是一个存在的问题。尚未采用明确的治疗策略来有效评估和处理这种发病率。应制定一种并发症最少的有效主要手术方法,以避免未来狭窄复发。涉及尿道狭窄患者的大规模研究可以收集足够的数据,以便为未来获得完整的治愈性治疗方案。

相似文献

4
[Stents in therapy of urethral strictures].[支架在尿道狭窄治疗中的应用]
Urologe A. 1998 Jan;37(1):51-5. doi: 10.1007/s001200050148.

本文引用的文献

7
Male urethral strictures and their management.男性尿道狭窄及其处理
Nat Rev Urol. 2014 Jan;11(1):43-50. doi: 10.1038/nrurol.2013.275. Epub 2013 Dec 17.

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