Wessells H, Morey A F, McAninch J W
Department of Urology, University of California School of Medicine and San Francisco General Hospital, 94110, USA.
J Urol. 1998 Oct;160(4):1373-5.
We report the reconstructive techniques used to correct obliterative vesicourethral strictures related to prostate cancer surgery.
Four men with anastomotic obliteration after radical prostatectomy underwent primary excision with end-to-end anastomosis, penile fasciocutaneous flap, free-graft urethroplasty with rectus muscle flap or anterior bladder tube with omental pedicle flap procedure.
At mean followup of 33.8 months all patients had urethral patency but none was continent.
Single stage reconstruction of the obliterated vesicourethral anastomosis after prostatectomy successfully restored urethral patency. No technique was applicable in all cases. Sphincteric function is likely to be compromised after the primary procedure, resulting in incontinence after successful urethral reconstruction. Subsequent artificial sphincter placement appears to be safe and helpful in restoring continence.
我们报告用于纠正与前列腺癌手术相关的闭塞性膀胱尿道狭窄的重建技术。
4例根治性前列腺切除术后吻合口闭塞的男性患者接受了端端吻合的初次切除、阴茎筋膜皮瓣、带腹直肌瓣的游离移植尿道成形术或带网膜蒂瓣的前膀胱管手术。
平均随访33.8个月时，所有患者尿道均通畅，但无一人控尿。
前列腺切除术后闭塞性膀胱尿道吻合口的一期重建成功恢复了尿道通畅。没有一种技术适用于所有病例。初次手术后括约肌功能可能受损，导致尿道重建成功后出现尿失禁。随后放置人工括约肌似乎对恢复控尿安全且有帮助。
