Gul Abdullah, Ekici Ozgur, Zengin Salim, Barali Deniz, Keskin Tarik
Department of Urology, University of Health Sciences, Bursa Yüksek İhtisas Education and Research Hospital, Bursa 16100, Türkiye.
Department of Urology, University of Health Sciences, Bursa City Hospital, Bursa 16000, Türkiye.
World J Clin Cases. 2024 May 16;12(14):2324-2331. doi: 10.12998/wjcc.v12.i14.2324.
Urethral stricture is a condition that often develops with trauma and results in narrowing of the urethral lumen. Although endoscopic methods are mostly used in its treatment, it has high recurrence rates. Therefore, open urethroplasty is recommended after unsuccessful endoscopic treatments.
To investigate the risk factors associated with urethral stricture recurrence.
The data of male patients who underwent internal urethrotomy for urethral stricture between January 2017 and January 2023 were retrospectively analyzed. Demographic data, comorbidities, preoperative haemogram, and biochemical values obtained from peripheral blood and operative data were recorded. Patients were divided into two groups in terms of recurrence development; recurrence and non-recurrence. Initially recorded data were compared between the two groups.
A total of 303 patients were included in the study. The mean age of the patients was 66.6 ± 13.6 years. The mean duration of recurrence development was 9.63 ± 9.84 (min-max: 1-39) months in the recurrence group. Recurrence did not occur in non-recurrence group throughout the follow-up period with an average time of 44.15 ± 24.07 (min-max: 12-84) months. In the comparison of both groups, the presence of diabetes mellitus (DM), hypertension (HT), and multiple comorbidities were significantly higher in the recurrence (+) group ( = 0.038, = 0.012, = 0.013). Blood group, postoperative use of non-steroidal anti-inflammatory drugs, preoperative cystostomy, cause of stricture, iatrogenic cause of stricture, location and length of stricture, indwelling urinary cathater size and day of catheter removal did not differ between the two groups. No statistically significant difference was observed between the two groups in terms of age, uroflowmetric maximum flow rate value, hemogram parameters, aspartate aminotransferase (AST), alanine aminotransferase (ALT), fasting blood sugar, creatinine, glomerular filtration rate, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, lymphocyte-monocyte ratio, monocyte-lymphocyte ratio and AST/ALT ratios.
In patients with urethral stricture recurrence, only the frequency of DM and HT was high, while inflammation marker levels and stricture-related parameters were similar between the groups.
尿道狭窄是一种常因创伤而发生的疾病，会导致尿道管腔狭窄。尽管内镜治疗方法在其治疗中应用最为广泛，但复发率较高。因此，在内镜治疗失败后，建议采用开放性尿道成形术。
探讨与尿道狭窄复发相关的危险因素。
回顾性分析2017年1月至2023年1月期间因尿道狭窄接受尿道内切开术的男性患者的数据。记录人口统计学数据、合并症、术前血常规以及从外周血获得的生化值和手术数据。根据复发情况将患者分为两组：复发组和未复发组。对两组最初记录的数据进行比较。
本研究共纳入303例患者。患者的平均年龄为66.6±13.6岁。复发组复发发生的平均时间为9.63±9.84（最小值 - 最大值：1 - 39）个月。在平均时间为44.15±24.07（最小值 - 最大值：12 - 84）个月的整个随访期内，未复发组均未出现复发。在两组比较中，复发（+）组中糖尿病（DM）、高血压（HT）和多种合并症的发生率显著更高（P = 0.038，P = 0.012，P = 0.013）。两组之间的血型、术后使用非甾体类抗炎药、术前膀胱造瘘术、狭窄原因、狭窄的医源性原因、狭窄部位和长度、留置导尿管尺寸以及拔管天数无差异。两组在年龄、尿流率最大流速值、血常规参数、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、空腹血糖、肌酐、肾小球滤过率、中性粒细胞 - 淋巴细胞比值、血小板 - 淋巴细胞比值、淋巴细胞 - 单核细胞比值、单核细胞 - 淋巴细胞比值以及AST/ALT比值方面均未观察到统计学上的显著差异。
在尿道狭窄复发的患者中，仅糖尿病和高血压的发生率较高，而两组之间炎症标志物水平和与狭窄相关的参数相似。
