Chalouhy E, Jabbour M, Armache K, Kassardjian Z, Moukarzel M, el-Khoury R, Chaiban R, Merhej S
Urology Department, Hôtel-Dieu de France Hospital, Beirut, Lebanon.
J Med Liban. 1997 Dec;45(4):201-5.
We reviewed our experience with 17 cases of posterior urethral disruption due to traumatic pelvic injuries. In all cases, a suprapubic cystostomy was performed at first. For blunt injuries, urethroplasty was delayed for 6 months in average. For most of the penetrating injuries (3/4), we performed immediate debridement and primary repair. Resulting bulbous or membranous strictures less than 3 cm long were treated with one-stage perineal excision-reanastomosis urethroplasty. Membranous strictures longer than 3 cm were managed with a combined transpubic-perineal repair, while bulbous defects longer than 3 cm were treated with a scrotal pedicled island flap. The overall restricture rate was 25%. Those having had initial repeated urethrotomies displayed a 100% restenosis rate. Incontinence rate was 12.5% Erectile dysfunction occurring in 42% of our patients is a sequela of the pelvic injury and was found to be directly related postoperatively to its presence at the time of surgery.
我们回顾了17例因创伤性骨盆损伤导致后尿道断裂的病例。所有病例均首先进行耻骨上膀胱造瘘术。对于钝性损伤，尿道成形术平均延迟6个月。对于大多数穿透性损伤（3/4），我们立即进行清创和一期修复。长度小于3 cm的球部或膜部狭窄采用一期会阴切除-端端吻合尿道成形术治疗。长度大于3 cm的膜部狭窄采用经耻骨-会阴联合修复，而长度大于3 cm的球部缺损采用阴囊带蒂岛状皮瓣治疗。总体狭窄率为25%。最初接受反复尿道切开术的患者再狭窄率为100%。尿失禁率为12.5%。42%的患者出现勃起功能障碍，这是骨盆损伤的后遗症，并且发现术后与手术时的存在直接相关。
