Kudriavtsev L A
Urol Nefrol (Mosk). 1994 May-Jun(3):20-4.
The choice of operative techniques applicable in urethral strictures and obliterations is rather great today. The author holds that procedures that may entail bladder hypotonia, pyelonephritis, nephrolithiasis, prostatitis, impotence, especially in young patients, should be rejected as ineffective. These complications often result from ignorance of perineal anatomy, erroneous choice of surgical policy leading to bouginage. To avoid it, the surgeon is advised to employ two-stage urethral reconstruction according to B. Johanson. The procedure, proposed in 1950, implies usage of plastic material obtained from penile and scrotal skin. The original variant of the procedure has the disadvantage of confinement only to urethral strictures. We use two new variants of Johanson operation which can abate not only strictures, but obliterations as well. The experience of 1-26-year follow-up indicates feasibility of our modified operations in multiple strictures in combination with other surgical interventions, in urethrorectal and perineal fistulas and in pediatric surgery.
如今，适用于尿道狭窄和闭锁的手术技术选择相当多。作者认为，那些可能导致膀胱张力减退、肾盂肾炎、肾结石、前列腺炎、阳痿的手术方法，尤其是对年轻患者而言，因其效果不佳应予以摒弃。这些并发症往往是由于对会阴解剖结构的无知、导致尿道扩张的手术策略选择错误所致。为避免此类情况，建议外科医生采用B. 约翰森提出的两阶段尿道重建术。该手术于1950年提出，意味着使用取自阴茎和阴囊皮肤的整形材料。该手术的原始变体仅适用于尿道狭窄，存在局限性。我们采用约翰森手术的两种新变体，它们不仅可以缓解狭窄，还能缓解闭锁。1至26年的随访经验表明，我们改良后的手术在治疗多发性狭窄并结合其他外科干预措施、尿道直肠瘘和会阴瘘以及小儿外科手术方面是可行的。
