Zhou Zheng-Xing, Chen Hong-Bing, Xu Guo-Sheng, Liu Wei, Liang Chao-Zhao, Sa Ying-Long
Department of Urology, The Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230061, China.
Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China.
Zhonghua Nan Ke Xue. 2021 Jul;27(7):621-625.
To investigate the efficiency and complications of modified urethral reconstruction with lingual mucosa in the treatment of complicated anterior urethral stricture (CAUS).
We retrospectively studied the clinical data on 10 cases of CAUS treated by modified urethral reconstruction with lingual mucosa from December 2017 to June 2019 concerning the age of the patients and the causes, location and length of urethral stricture. We statistically analyzed the pre- and post-operative maximum urine flow rate (Qmax), scores on Mental Status Scale in Non-psychiatric Settings (MSSNS) and quality of life (QOL) scores and observed post-operative complications such as abnormal taste, tongue numbness, urinary tract infection, urethral diverticulum, and urethral stricture.
Compared with the baseline, Qmax was significantly improved and the MSSNS and QOL scores dramatically decreased at 3, 6 and 12 months after surgery (P < 0.01). Paraurethral infection developed in 1 case postoperatively, which was cured after dressing change, external urethral orifice stenosis occurred in another, which was improved after regular urethral orifice expansion, and mild tongue numbness was found in 2 cases at 1 month but gradually restored to abnormal. Urethrography showed no urethral diverticulum before catheter removal.
Lingual mucosa is an ideal alternative material for urethral reconstruction in the treatment of CAUS, and lateral lingual mucosa can be easily obtained. Modified urethral reconstruction by embedding lingual mucosa in the dorsal base of the urethra, with the advantages of definite effectiveness and few postoperative complications, is worthy of clinical application.
探讨改良舌黏膜尿道重建术治疗复杂性前尿道狭窄（CAUS）的疗效及并发症。
回顾性分析2017年12月至2019年6月采用改良舌黏膜尿道重建术治疗的10例CAUS患者的临床资料，包括患者年龄、尿道狭窄的病因、部位及长度。对术前、术后最大尿流率（Qmax）、非精神科环境下精神状态量表（MSSNS）评分及生活质量（QOL）评分进行统计学分析，并观察术后并发症，如味觉异常、舌麻木、尿路感染、尿道憩室及尿道狭窄。
与基线相比，术后3、6和12个月时Qmax显著改善，MSSNS和QOL评分显著降低（P<0.01）。术后1例发生尿道旁感染，经换药治愈；另1例出现尿道口狭窄，经定期尿道口扩张后改善；2例术后1个月出现轻度舌麻木，但逐渐恢复正常。拔管前尿道造影未见尿道憩室。
舌黏膜是治疗CAUS尿道重建的理想替代材料，舌侧黏膜易于获取。将舌黏膜嵌入尿道背侧基部的改良尿道重建术疗效确切，术后并发症少，值得临床应用。
