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球部尿道支架治疗球部尿道狭窄:支架取出后的长期随访。

Bulbar Urethral Stents for Bulbar Urethral Strictures: Long-Term Follow-Up after Stent Removal.

机构信息

Department of Urology, Derince Training and Research Hospital, Kocaeli, Turkey.

Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey.

出版信息

Urol Int. 2022;106(3):243-248. doi: 10.1159/000514417. Epub 2021 May 5.

Abstract

BACKGROUND/AIM: The aim of this study was to assess long-term clinical efficacy of temporary bulbar urethral stent (BUS) used for treatment of recurrent bulbar urethral stricture (US).

MATERIALS AND METHODS

A total of 168 patients with recurrent bulbar US who underwent BUS placement after internal urethrotomy between 2009 and 2019 were enrolled. An indwelling time of 12 months was planned for the stents. After stent removal, the criteria for success of BUS treatment were defined as follows: no evidence of stricture on urethrogram or endoscopy, more than 15 mL/s of urinary peak flow, and no recurrent urinary tract infections. Patients were divided into 2 groups based on clinical success and compared.

RESULTS

The mean age, US length, and indwelling time were 46.7 (±8.3) years, 2.32 (±0.4) cm, and 9.7 (±2.3) months, respectively. Median (range) follow-up was 71 (8-86) months. Clinical success was achieved in 77.9% patients. Longer indwelling time (8-18 [81.88%] vs. 3-7 [60%] months) and US length <2 cm (84.25% [<2 cm] vs. 58.5% [≥2 cm]) were significantly associated with clinical success (p < 0.05).

CONCLUSION

This study is both the largest patient series and the longest follow-up for BUS in bulbar US. Our results suggest that BUS can be a safe and minimally invasive treatment alternative among bulbar US treatment options.

摘要

背景/目的:本研究旨在评估暂时性球部尿道支架(BUS)治疗复发性球部尿道狭窄(US)的长期临床疗效。

材料和方法

2009 年至 2019 年期间,共有 168 例复发性球部 US 患者在尿道内切开术后接受 BUS 置入,计划支架留置时间为 12 个月。支架取出后,BUS 治疗成功的标准定义为:尿道造影或内窥镜检查无狭窄证据、尿流峰值超过 15mL/s 且无复发性尿路感染。根据临床成功情况将患者分为两组进行比较。

结果

患者平均年龄为 46.7(±8.3)岁,US 长度为 2.32(±0.4)cm,支架留置时间为 9.7(±2.3)个月。中位(范围)随访时间为 71(8-86)个月。77.9%的患者达到临床成功。较长的支架留置时间(8-18 [81.88%] vs. 3-7 [60%] 个月)和 US 长度<2cm(84.25% [<2cm] vs. 58.5% [≥2cm])与临床成功显著相关(p<0.05)。

结论

本研究是 BUS 治疗球部 US 患者中最大的病例系列和最长的随访研究。我们的结果表明,BUS 是球部 US 治疗选择中一种安全且微创的替代治疗方法。

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