Duel B P, Barthold J S, Gonzalez R
Department of Pediatric Urology, Children's Hospital of Michigan and Wayne State University Medical School, Detroit, USA.
J Urol. 1998 Jul;160(1):170-1.
We conducted a retrospective study of patients with strictures after hypospadias repair to identify factors contributing to the development of strictures and to attempt to define an optimal strategy for management.
Patients with the diagnosis of hypospadias who had undergone direct vision internal urethrotomy, urethral dilation or urethroplasty were identified. The original location of the meatus, type of initial repair, subsequent procedures and outcome of the interventions were recorded.
A total of 38 patients were identified. Of the 29 patients who were initially treated with direct vision internal urethrotomy or urethral dilation 23 (79%) ultimately required open urethroplasty and did well. Of the 8 patients treated with initial urethroplasty 7 had successful outcomes. Overall success, defined as asymptomatic voiding without fistula or residual stricture, was 78% at a mean followup of 6.3 years.
Stricture disease continues to be a significant complication of hypospadias reconstruction. Initial therapy should be urethral dilation but it should be recognized that the majority of these patients will ultimately require open urethroplasty.
我们对尿道下裂修复术后出现狭窄的患者进行了一项回顾性研究，以确定导致狭窄发生的因素，并试图确定一种最佳的治疗策略。
确定诊断为尿道下裂且接受了直视下内切开术、尿道扩张术或尿道成形术的患者。记录尿道口的原始位置、初始修复类型、后续治疗步骤及干预结果。
共确定了38例患者。在最初接受直视下内切开术或尿道扩张术治疗的29例患者中，23例（79%）最终需要进行开放性尿道成形术且效果良好。在最初接受尿道成形术治疗的8例患者中，7例获得了成功的结果。总体成功率定义为无症状排尿且无瘘管或残余狭窄，在平均随访6.3年时为78%。
狭窄疾病仍然是尿道下裂重建的一个重要并发症。初始治疗应为尿道扩张，但应认识到这些患者中的大多数最终将需要进行开放性尿道成形术。
