Pathak Himadri, Purkait Bimalesh, Hameed Shahid, Das Anjan Kumar, Sarkar Kaushik, Ghoshal Prithwiraj
Department of Urology, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, India.
Urol Ann. 2023 Jan-Mar;15(1):22-26. doi: 10.4103/ua.ua_196_21. Epub 2022 Sep 16.
Patients suffering from stricture urethra and deranged renal function have poor quality of life. The incidence of urethral stricture co-existing with renal failure is comparatively small and cause may be multifactorial. There is paucity of literature on management of urethral stricture associated with deranged renal function. We present our experience of managing stricture urethra associated with chronic renal failure.
This was a retrospective study conducted from 2010 to 2019. Patients with stricture urethra and deranged renal function (serum creatinine >1.5 mg/dl) who underwent urethroplasty or perineal urethrostomy were included in our study. A total of 47 patients met the inclusion criteria and were included in this study. Patients were followed every 3 months in their 1 year of surgery and 6 monthly thereafter. Statistical analysis was done using SPSS version 16.
There was a significant increase in the mean postopérative maximum and average urinary flow rates when compared to the preoperative values. The overall success rate was 76.59%. Out of 47 patients, 10 had wound infection and delayed wound healing, 2 patients developed ventricular arrhythmias, 6 patients developed fluid and electrolyte imbalance, 2 patients developed seizures, and 1 patient developed septicemia in the postoperative period.
Prevalence of patients with chronic renal failure associated with stricture urethra was 4.58% and features suggestive of deranged renal function at presentation were present in 1.81% patients. In the present study, complications related with chronic renal failure occurred in 17 (36.17%) patients. Multidisciplinary care of the patient along with appropriate surgical management is a viable option in this sub-group of patients.
患有尿道狭窄和肾功能紊乱的患者生活质量较差。尿道狭窄与肾衰竭并存的发生率相对较低,其病因可能是多因素的。关于合并肾功能紊乱的尿道狭窄的治疗,相关文献较少。我们在此介绍我们治疗与慢性肾衰竭相关的尿道狭窄的经验。
这是一项于2010年至2019年进行的回顾性研究。纳入了接受尿道成形术或会阴尿道造口术的尿道狭窄且肾功能紊乱(血清肌酐>1.5mg/dl)的患者。共有47例患者符合纳入标准并被纳入本研究。患者在术后1年内每3个月随访一次,此后每6个月随访一次。使用SPSS 16版进行统计分析。
与术前值相比,术后平均最大尿流率和平均尿流率显著增加。总体成功率为76.59%。47例患者中,10例出现伤口感染和伤口愈合延迟,2例发生室性心律失常,6例出现液体和电解质失衡,2例发生癫痫发作,1例在术后发生败血症。
与尿道狭窄相关的慢性肾衰竭患者的患病率为4.58%,就诊时提示肾功能紊乱的特征在1.81%的患者中存在。在本研究中,17例(36.17%)患者发生了与慢性肾衰竭相关的并发症。对该亚组患者进行多学科护理并结合适当的手术治疗是一种可行的选择。