Steiner M S, Burnett A L, Brooks J D, Brendler C B, Stutzman R E, Carter H B
Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Urol. 1993 Aug;150(2 Pt 1):407-9; discussion 409-10. doi: 10.1016/s0022-5347(17)35494-0.
A 1.5 cm. tubularized neourethra was formed using an anterior bladder flap as part of bladder neck reconstruction after radical retropubic prostatectomy in 69 consecutive patients with clinically localized prostate cancer (study group). Postoperative continence (defined as requiring no protection for any activity) was assessed by history at 3 months (all men) and 6 months (45 of 69 men). Continence in the study group was compared to that of 45 men with 6 months of followup who underwent radical retropubic prostatectomy without tubularization of the anterior bladder (control group). At 3 months 38 of 69 men (55%) were continent in the study group and 14 of 45 (31%) were continent in the control group (p < 0.03). At 6 months 39 of 45 men (87%) were continent in the study group compared to 21 of 45 (47%) in the control group (p < 0.01). Upright cystograms performed on men with and without the tubularized neourethra after radical retropubic prostatectomy suggest that a neourethra proximal to the external sphincter may increase resistance in this area and result in early return of urinary control in men undergoing radical retropubic prostatectomy.
在69例临床局限性前列腺癌患者（研究组）中，根治性耻骨后前列腺切除术后，使用膀胱前壁皮瓣形成1.5厘米的管状新尿道作为膀胱颈重建的一部分。术后3个月（所有男性）和6个月（69例中的45例男性）通过病史评估尿失禁情况（定义为任何活动都无需保护）。将研究组的尿失禁情况与45例接受根治性耻骨后前列腺切除术但未进行膀胱前壁管状化的男性（对照组）进行比较，随访6个月。研究组69例男性中38例（55%）在3个月时控尿，对照组45例中14例（31%）控尿（p<0.03）。研究组45例男性中39例（87%）在6个月时控尿，而对照组45例中21例（47%）控尿（p<0.01）。对根治性耻骨后前列腺切除术后有或没有管状新尿道的男性进行的直立膀胱造影显示，外括约肌近端的新尿道可能会增加该区域的阻力，并导致接受根治性耻骨后前列腺切除术的男性早期恢复尿控。
