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经尿道前列腺切除术治疗后发生的球部-膜部尿道狭窄行腹侧黏膜下移植尿道成形术的疗效。

Outcomes of Ventral Onlay Buccal Mucosal Graft Urethroplasty in Bulbomembranous Urethral Strictures Post-transurethral Resection of the Prostate.

机构信息

Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt.

Department of Urology, Heartland Regional Hospital, Marion, IL.

出版信息

Urology. 2024 Apr;186:9-14. doi: 10.1016/j.urology.2024.01.018. Epub 2024 Feb 23.

Abstract

OBJECTIVE

To evaluate the outcomes of ventral onlay buccal mucosal graft urethroplasty (VOBMGU) in bulbomembranous urethral strictures after transurethral resection of the prostate.

METHODS

After approval of the institutional ethical committee, we retrospectively examined the database of patients diagnosed with post-TURP urethral stricture (PTS) and treated by VOBMGU from January 2020 to January 2022. The patients were evaluated by retrograde urethrogram and voiding cystourethrogram. Follow-up evaluation included assessment of lower urinary tract symptoms, physical examination, uroflowmetry (Q-max and International Prostate Symptom Score) 3, 6, and 12months of follow-up.

RESULTS

A total of 30 patients underwent VOBMGU for bulbomembranous PTS were included. The median age of the patients was 63.5 (11.25). The median stricture length was 3.5 (1.5) cm. During follow-up, the mean Q-max significantly increased to 21.1 ± 5.5 mL/s (P < .0001), 20.1 ± 5.4 mL/s (P < .001), and 19.1 ± 5.3 mL/s (P < .003) at 3, 6, and 12months, respectively. IPSS significantly decreased to 8.93 ± 6.37 at the 12-month follow-up mark (P < .0001). Three patients developed stricture recurrence and two patients developed postoperative urinary incontinence.

CONCLUSION

VOBMGU in cases of bulbomembranous urethral PTS offered excellent functional outcomes with low stricture recurrence and minimal risk of incontinence. Further prospective studies are warranted to confirm the results.

摘要

目的

评估经尿道前列腺切除术(TURP)后尿道球部膜部尿道狭窄行腹侧黏膜下移植尿道成形术(VOBMGU)的治疗效果。

方法

在机构伦理委员会批准后,我们回顾性分析了 2020 年 1 月至 2022 年 1 月期间因 TURP 后尿道狭窄(PTS)行 VOBMGU 治疗的患者数据库。患者通过逆行尿道造影和排尿性膀胱尿道造影进行评估。随访评估包括下尿路症状评估、体格检查、尿流率(Q-max 和国际前列腺症状评分),随访 3、6 和 12 个月。

结果

共 30 例患者因球部膜部 PTS 行 VOBMGU 治疗。患者的中位年龄为 63.5(11.25)岁。中位狭窄长度为 3.5(1.5)cm。在随访期间,平均 Q-max 显著增加,分别为 21.1±5.5 mL/s(P<0.0001)、20.1±5.4 mL/s(P<0.001)和 19.1±5.3 mL/s(P<0.003),分别在 3、6 和 12 个月时。12 个月随访时 IPSS 显著下降至 8.93±6.37(P<0.0001)。3 例患者发生狭窄复发,2 例患者发生术后尿失禁。

结论

VOBMGU 治疗球部膜部尿道 PTS 可获得良好的功能结果,狭窄复发率低,尿失禁风险极小。需要进一步的前瞻性研究来证实这些结果。

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