Wang Ying, Liu Meng, Jin Chongrui, Song Lujie, Yang Ranxing, Fu Qiang
Department of Urology, Shanghai Sixth People's Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Eastern Institute of Urologic Reconstruction, Shanghai, 200233, China.
World J Urol. 2025 Jan 17;43(1):77. doi: 10.1007/s00345-025-05442-6.
To determine the clinical effects of urethral suspension-assisted urethral anastomosis on complex long-segment posterior urethral stricture and describe the technical aspects of this procedure.
The clinical data for 24 patients who underwent urethral suspension-assisted urethral anastomosis for complex long-segment posterior urethral stricture between March 2021 and March 2024 were retrospectively analyzed. The surgical procedure comprises the following four steps: creation of an inverted Y-shaped incision in the perineum; mobilization of the urethra up to the penile-scrotal junction followed by dissection and separation of the septum of the corpus cavernosum; separation of the inferior pubic symphysis, excising a portion of the inferior pubic symphysis bone tissue and thoroughly clearing the scar tissue surrounding the proximal urethra; and suturing and suspension of the proximal urethra and surrounding tissues at the 2, 5, 7, and 10 o'clock positions, ensuring complete exposure of the proximal urethral mucosa and tension-free anastomosis between the proximal and distal urethra.
The mean patient age was 46.7 years (range 27-64) and the median urethral stricture length was 5.1 cm. The urethral catheter was removed 4 weeks postoperatively. The median follow-up duration was 13.6 months (4-32). Urinary flow remained unobstructed in 22 patients (91.7%), with an average maximum flow rate of 24.5 ml/s (15.3-36.2). Urethral stricture recurred post-surgery in two patients, one of whom underwent successful repair with the same surgical procedure while the other achieved successful voiding after urethrotomy.
Urethral suspension-assisted urethral anastomosis is an effective treatment for complex long-segment posterior urethral stricture. This technique allows for optimal exposure of the proximal urethral mucosa, reduces the distance between the proximal and distal urethra, simplifies surgical procedures, enables tension-free anastomosis between the proximal and distal urethra, and has a high success rate.
确定尿道悬吊辅助尿道吻合术治疗复杂性长段后尿道狭窄的临床效果，并描述该手术的技术要点。
回顾性分析2021年3月至2024年3月期间24例行尿道悬吊辅助尿道吻合术治疗复杂性长段后尿道狭窄患者的临床资料。手术步骤包括以下四个步骤：在会阴处做倒Y形切口；将尿道游离至阴茎阴囊交界处，然后解剖并分离海绵体中隔；分离耻骨下联合，切除部分耻骨下联合骨组织，彻底清除近端尿道周围的瘢痕组织；在2点、5点、7点和10点位置对近端尿道和周围组织进行缝合和悬吊，确保近端尿道黏膜完全暴露，近端和远端尿道无张力吻合。
患者平均年龄46.7岁（范围27 - 64岁），尿道狭窄中位长度为5.1 cm。术后4周拔除尿道导管。中位随访时间为13.6个月（4 - 32个月）。22例患者（91.7%）排尿通畅，平均最大尿流率为24.5 ml/s（15.3 - 36.2）。2例患者术后尿道狭窄复发，其中1例采用相同手术成功修复，另1例经尿道切开术后成功排尿。
尿道悬吊辅助尿道吻合术是治疗复杂性长段后尿道狭窄的有效方法。该技术可使近端尿道黏膜最佳暴露，缩短近端和远端尿道距离，简化手术操作，实现近端和远端尿道无张力吻合，成功率高。
