Schlossberg S, Jordan G, Schellhammer P
Department of Urology, Eastern Virginia Medical School, Norfolk.
Urology. 1995 Mar;45(3):510-3. doi: 10.1016/S0090-4295(99)80025-9.
We present the open surgical repair of complete obstruction of the bladder neck unresponsive to endoscopic management. By combining abdominal and perineal dissection, partial pubectomy, and omental wrapping, repeat anastomosis is possible without the need for bladder tubularization. Two patients have been repaired successfully. Although both men presented with indwelling suprapubic tubes and a defect of greater than 1.5 cm, they are now voiding normally at 18 and 7 months post-operatively without the need for pads, medication, or instrumentation. Complete obliteration of the bladder neck after radical prostatectomy can be functionally reconstructed. Postoperative continence will depend on the function of the membranous urethra. If incontinence occurs, this can be managed in a reconstructed open urethra.
我们展示了对内镜治疗无反应的膀胱颈完全梗阻的开放性手术修复方法。通过联合腹部和会阴解剖、部分耻骨切除术及网膜包裹，无需膀胱管状化即可进行重复吻合。两名患者已成功修复。尽管两名男性患者均留置耻骨上导尿管且缺损大于1.5厘米，但他们现在术后18个月和7个月时排尿正常，无需使用尿垫、药物或器械。根治性前列腺切除术后膀胱颈的完全闭塞可进行功能性重建。术后控尿将取决于膜部尿道的功能。如果出现尿失禁，可在重建的开放尿道中进行处理。
