Koraitim M
J Urol. 1985 Mar;133(3):408-10. doi: 10.1016/s0022-5347(17)48997-x.
Various types of urethroplasty and visual urethrotomy should not be regarded as competitive with each other for a particular case of urethral stricture. Rather, they should be regarded as complementary procedures available for the cure of different types of strictures, with each having its indications as well as limitations. In cases of post-traumatic strictures and disruption the best solution is complete excision of the pathological segment and bulboprostatic anastomosis, either through the perineum when prostatic displacement is absent or minimal, or by the transpubic route when the displacement is great. Post-inflammatory strictures should be corrected by a 2-stage urethroplasty with exteriorization of the diseased urethra. Internal visual urethrotomy is reserved for short post-traumatic strictures that are limited in length, circumference and depth. Free skin grafts are best suited to cover small defects after urethroplasty.
各种类型的尿道成形术和直视下尿道切开术不应被视为在治疗特定尿道狭窄病例时相互竞争的方法。相反，它们应被视为可用于治疗不同类型狭窄的互补性手术，每种手术都有其适应症和局限性。对于创伤后狭窄和断裂的病例，最佳解决方案是完全切除病变段并进行球部-前列腺吻合术，当前列腺移位不存在或很小时，可通过会阴途径进行，当移位较大时，则通过耻骨途径进行。炎症后狭窄应通过两阶段尿道成形术并将病变尿道外置来矫正。直视下尿道内切开术适用于长度、周长和深度有限的创伤后短狭窄。游离皮片最适合覆盖尿道成形术后的小缺损。
