Joshi Pankaj M, Hevia Manuel, Sreeranga Yatam Lakshmi, Bandini Marco, Patil Amey, Bhadranavar Shreyas, Sharma Vipin, Bafna Sandeep, Kulkarni Sanjay B
Kulkarni Reconstructive Urology Center, 3, Rajpath Society, Paud Road, Pune 411038, India.
Urology Department, Ramón y Cajal University Hospital, IRYCIS, University of Alcalá, Madrid, Spain.
Asian J Urol. 2023 Oct;10(4):512-517. doi: 10.1016/j.ajur.2021.11.001. Epub 2021 Nov 11.
Incidences of post-transurethral resection of the prostate (post-TURP) strictures are between 2.2% and 9.8%. Stricture commonly occurs within the first 6 months. Our objective was to assess the outcomes of patients with obliterative strictures post-TURP that underwent a double-face urethroplasty.
This is a single-center prospective study of 17 patients with obliterative proximal bulbar stricture post-TURP who underwent double-face graft urethroplasty by two surgeons between January 2014 and January 2020. We defined post-TURP obliterative strictures as those patients who presented with complete or almost complete obstruction of the urethral lumen and who have had a history of acute urine retention. We have excluded patients with bladder neck contracture. Primary outcome was treatment success, defined as the no need for further treatments. Secondary outcome was post-urethroplasty continent rate.
Seventeen patients were included in the study with median age of 66 (interquartile range 40-77) years; median time of follow-up was 24 (interquartile range 12-84) months; median stricture length was 4 (interquartile range 2-6) cm. Of the 17 patients, 15 (88.2%) were successful. All patients were continent after urethroplasty.
With mid-term follow-up, treatment of obliterative proximal bulbar strictures with double-face buccal mucosa graft is a safe and effective procedure. Obliterative proximal bulbar strictures merit double-face urethroplasty with high-rate success and functional outcomes.
经尿道前列腺电切术（TURP）后尿道狭窄的发生率在2.2%至9.8%之间。狭窄通常发生在术后6个月内。我们的目的是评估接受双面尿道成形术的TURP术后闭锁性狭窄患者的治疗效果。
这是一项单中心前瞻性研究，纳入了17例TURP术后近端球部闭锁性狭窄患者，于2014年1月至2020年1月期间由两位外科医生为其实施双面颊黏膜移植尿道成形术。我们将TURP术后闭锁性狭窄定义为那些出现尿道腔完全或几乎完全梗阻且有急性尿潴留病史的患者。我们排除了膀胱颈挛缩患者。主要结局指标为治疗成功，定义为无需进一步治疗。次要结局指标为尿道成形术后的控尿率。
17例患者纳入研究，年龄中位数为66岁（四分位间距40 - 77岁）；随访时间中位数为24个月（四分位间距12 - 84个月）；狭窄长度中位数为4 cm（四分位间距2 - 6 cm）。17例患者中，15例（88.2%）治疗成功。所有患者尿道成形术后均能控尿。
经过中期随访，采用双面颊黏膜移植治疗近端球部闭锁性狭窄是一种安全有效的方法。近端球部闭锁性狭窄值得采用双面尿道成形术，其成功率高且功能预后良好。
