舌黏膜尿道成形治疗尿道狭窄的初步报告

A preliminary report of lingual mucosa urethroplasty for the treatment of urethral stricture

目的：探讨舌黏膜补片法尿道成形治疗尿道狭窄的疗效.方法：采用舌黏膜尿道成形治疗尿道狭窄14例.尿道狭窄段3.5～14 cm,平均6.2 cm;术前耻骨上膀胱造瘘8例,余6例排尿均较为困难,最大尿流率2.5～5.5 ml/s,平均3.8 ml/s.结果：术后随访2～8个月,1例因伤口感染致尿道皮肤瘘,余患者均排尿通畅,最大尿流率增至22～51 ml/s,平均29.6 ml/s.结论：舌黏膜具有取材方便、对患者创伤小、抗感染力强等特点,是一种较好的尿道替代物,尤其适合尿道狭窄段＜6 cm的患者.

Objective：To investigate the value of onlay urethroplasty with lingual mucosa for the treatment of urethral stricture. Methods：A total of 14 patients （average age 34, range 24 to 56） underwent lingual mucosa onlay urethroplasty during August 2006 and February 2007 for urethral stricture. Among the 14 patients, 10 underwent suprapubic cystostomy, the others presented with strangury and their peak flow rates ranged 2.5 to 5. 5 ml/s （mean 3.8 ml/s）, Onlay urethroplasty with a free graft of lingual mucosa ranged from 3.5 cm to 14 cm （mean 6. 2 cm）. Results：The patients were followed up 2-8 months postoperatively. Of the 14 patients, 1 was complicated with urinary fistula, the other patients were voiding well. The peak flow rates ranged between 22 and 51 ml/s （mean 29.6 ml/s）. Conclusions：Lingual mucosa for urethroplasty has advantages of easy to harvest, mini trauma to patient and a strong resistance to infection, especially for the treatment of urethral stricture 〈 6 cm in length.