改良尿道口成形术治疗复发性下尿路感染伴尿道外口处女膜融合

Application of modified urethra meatus plasty in the treatment of urethral hymenal fusion with recurrent lower urinary tract infection

目的探讨改良尿道口成形术治疗复发性下尿路感染(LUTI)伴尿道外口处女膜融合的安全性和有效性。方法回顾性分析2016年7月—2023年1月于北京和睦家医院泌尿外科接受改良尿道口成形术治疗的15例复发性LUTI伴尿道外口处女膜融合的女性患者的临床资料。手术改良之处:在尿道外口下缘与阴道处女膜上缘之间横行切开皮肤,分离尿道与阴道间隙,然后纵行缝合切口,从而使尿道外口与阴道处女膜上缘距离保持在1.5 cm以上。采用随访问卷评估临床治疗结果。结果15例患者均顺利完成手术,围手术期无切口感染,无继发性出血等Clavien-DindoⅠ级以上并发症发生。平均随访48(18~96)个月,治愈11例,好转4例,治愈率+好转率为100%。所有接受手术的患者均表示会推荐有类似病症的患者接受此项手术治疗。结论改良尿道口成形术是治疗复发性LUTI伴尿道外口处女膜融合的一种安全、有效的方法。

Objective To assess the safety and efficacy of modified urethra meatus plasty in the treatment of recurrent lower urinary tract infection(LUTI)with urethral hymenal fusion.Methods The clinical data of 15 female patients with recurrent LUTI and urethral hymenal fusion treated with modified urethra meatus plasty during Jul.2016 and Jan.2023 in our hospital were retrospectively analyzed.The surgical method was to make skin incision horizontally between the lower margin of the urethra and the upper margin of the vaginal hymen,separate the space between the urethra and the vagina,and then suture the incision longitudinally to maintain the distance between the urethra and the vaginal hymen upper margin at more than 1.5 cm.Clinical outcomes were assessed using a follow-up questionnaire.Results All operations were successful,with no Clavien-Dindo gradeⅠor above complications such as wound infection or secondary bleeding during perioperative period.During the follow-up of 48(18-96)months,11 cases were cured,and 4 cases were improved.The cure and improvement rate was 100%.All patients who underwent the surgery would recommend patients with similar conditions to undergo this surgery.Conclusion Modified urethra meatus plasty is a safe and effective surgical treatment for recurrent LUTI with urethral hymenal fusion.