Department of Urology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkiye.
Department of Urology, Ürgüp State Hospital, Nevşehir, Turkiye.
Turk J Med Sci. 2024 May 11;54(4):771-777. doi: 10.55730/1300-0144.5848. eCollection 2024.
BACKGROUND/AIM: This study describes ventral-approach augmented nontransected anastomotic (vANTA) urethroplasty and presents the preliminary functional results of patients treated with this technique.
Twenty-three patients who underwent vANTA urethroplasty were included in the study. Stricture location, stricture length, preoperative uroflowmetry parameters (maximum flow rate (Qmax) and mean flow rate (Qmean)), preoperative International Index of Erectile Function (IIEF)-5 scores, operation time, postoperative complications, length of hospital stay, and follow-up periods were recorded. The Qmax, Qmean, and IIEF-5 scores of the patients were recorded again in the second and twelfth postoperative months. Preoperative and postoperative Qmax values and IIEF-5 scores were compared. Kaplan-Meier survival analysis was performed to demonstrate recurrence-free survival.
The mean age of the patients included in the study was 52.1 ± 16.9 years. Mean stricture length was 2.5 ± 0.5 cm. There was a statistically significant difference between preoperative and 2-month postoperative uroflowmetry Qmax values (6.9 (0.0-14.5) vs. 18.5 (5.5-41.5) mL/s; p < 0.001). There was no statistically significant difference in preoperative and 2-month postoperative IIEF-5 scores (p > 0.05). There was a statistically significant difference between preoperative and 1-year postoperative median Qmax values (7.2 (0.0-12.3) vs. 17.4 (11.2-24.3) mL/s; p = 0.001). There was no statistically significant difference between preoperative and 1-year postoperative IIEF-5 scores (p > 0.05). According to Kaplan-Meier recurrence-free survival analysis, the recurrence-free survival rate at 6 months was 95.7.
In cases of bulbar urethral strictures, vANTA urethroplasty is an effective treatment option with limited postoperative complications. Preserving the underlying corpus spongiosum is important to avoid impaired sexual function.
背景/目的：本研究描述了经腹侧入路非横断吻合（vANTA）尿道成形术，并介绍了采用该技术治疗的患者的初步功能结果。
本研究纳入了 23 例接受 vANTA 尿道成形术的患者。记录狭窄部位、狭窄长度、术前尿流率参数（最大流率（Qmax）和平均流率（Qmean））、术前国际勃起功能指数（IIEF-5）评分、手术时间、术后并发症、住院时间和随访时间。在术后第 2 个月和第 12 个月再次记录患者的 Qmax、Qmean 和 IIEF-5 评分。比较了患者术前和术后的 Qmax 值和 IIEF-5 评分。进行 Kaplan-Meier 生存分析以展示无复发生存率。
研究纳入患者的平均年龄为 52.1±16.9 岁。平均狭窄长度为 2.5±0.5cm。术前和术后 2 个月尿流率 Qmax 值有统计学显著差异（6.9（0.0-14.5）比 18.5（5.5-41.5）mL/s；p<0.001）。术前和术后 2 个月 IIEF-5 评分无统计学显著差异（p>0.05）。术前和术后 1 年的中位 Qmax 值有统计学显著差异（7.2（0.0-12.3）比 17.4（11.2-24.3）mL/s；p=0.001）。术前和术后 1 年的 IIEF-5 评分无统计学显著差异（p>0.05）。根据 Kaplan-Meier 无复发生存分析，6 个月时无复发生存率为 95.7%。
在球部尿道狭窄的情况下，vANTA 尿道成形术是一种有效的治疗选择，术后并发症有限。保留固有海绵体对避免性功能受损很重要。
