尿道黏膜下注射维拉帕米预防前尿道狭窄尿道内切开后的复发:24个月随访证实钙离子阻滞的作用(英文)

Submucosal injection of verapamil prevents anterior urethral stricture recurrence following internal urethrotomy Role of calcium ion blocker confirmed by a 24-month follow-up

背景：尿道内切开术治疗前尿道狭窄简单易行,但存在远期狭窄复发率高的缺点.目的：观察尿道黏膜下注射维拉帕米在预防前尿道狭窄尿道内切开术后狭窄复发中的作用.方法：纳入2006-12/2008-04在福建医科大学附属第一医院泌尿外科治疗的前尿道狭窄患者60例,随机分为2组：一组行尿道内切开,另一组在行尿道内切开的同时加用维拉帕米行尿道黏膜下注射.所有患者至少随访24个月.结果与结论：患者随访24~39个月,平均28.5个月.尿道内切开组中有8例狭窄复发,而尿道内切开同时加用维拉帕米黏膜下注射组中仅有2例尿道狭窄复发.两组间比较差异有显著性意义（P 〈 0.05）.说明尿道内切开同时加用维拉帕米行尿道黏膜下注射可以预防内切开后尿道狭窄的复发,但更确切的结论需要更长时间的随访和更多病例来证实.

BACKGROUND： It is easy and feasible to treat anterior urethral stricture using internal urethrotomy, however, its drawback is high recurrence in the long-term follow-up. OBJECTIVE： To evaluate the effect of submucosal injected verapamil on prevention of anterior urethral stricture recurrence after internal urethrotomy. METHODS： Totally 60 consecutive males with anterior urethral stricture underwent internal urethrotomy with or without urethral submucosal injection of verapamil, in the Department of Urology, First Affiliated Hospital of Fujian Medical University, from December 2006 to April 2008, were selected. All cases were followed up at least 24 months.RESULTS AND CONCLUSION： All cases were followed up for 24-39 months, with an average of 28.5 months. Urethral stricture recurred in two cases in the verapamil-treated group but 8 cases in the untreated group. This difference in stricture recurrence between the two groups was statistically significant （P 〈 0.05）. The results demonstrated that submucosal injection of verapamil at the stricture site significantly reduces the stricture recurrence rate after internal urethrotomy. Further studies involving larger number of cases and longer follow-up are warranted to confirm the efficacy and safety of this therapy.