口腔黏膜尿道成形治疗硬化性苔藓样病所致尿道狭窄的疗效

Curative effect of buccal mucous membrane urethra shaping in treatment of hardening moss samples disease caused -urethral stricture

目的：探讨口腔黏膜尿道成形治疗硬化性苔藓样病（lichen sclerosus ，LS）所致尿道外口及前尿道狭窄的方法及疗效，提高对LS所致尿道狭窄的认识。方法2008年3月至2013年6月，收治LS所致前尿道狭窄患者12例，手术年龄为26~68岁，平均为42岁。狭窄段长度为1.5~8cm，平均为4.32cm。最大尿流率2.9~6.8mL/s，平均为4.24mL/s。将狭窄段尿道沿尿道外口纵形切开，采用口腔黏膜（颊黏膜或舌黏膜）分期或一期尿道成形治疗尿道外口及前尿道狭窄。结果12例患者手术后排尿通畅，随访6~55月，平均25月，至今有2例出现尿道外口再次狭窄，行尿道外口切开后排尿通畅，最大尿流率14.9~36.8mL/s，平均为21.13mL/s。讨论口腔颊黏膜和舌黏膜是尿道重建中良好的替代物，口腔黏膜分期或一期尿道成形是治疗LS所致尿道狭窄的有效方法。

Objective To explore the diagnosis and treatment of sclerosing moss samples （lichen sclerosus, LS） caused- urethral mouth and anterior urethral strictureand improve the understanding of urethral stricture. Methods From March 2008 to June 2013, total of 12 patients with LS caused-urethral stricture whose surgery age was 26~68, an average of 42, were enrolled in the study. Length of urethral stricture was 1.5~8 cm, with an average of 4.32 cm. Maximum urinary flow rate was 2.9~6.8 mL/s, with an average of 4.24 mL/s. Buccal mucosa （buccal mucosa or tongue mucosa） forming stage was used to treat urethral mouth and anterior urethral stricture along the urethral mouth stricture urethra longitudinal incision. Results Postoperative voiding of all patients was opened. All 12 patients were followed up for 6~55 months with an average of 25 months. Up to now, 2 cases appeared urethral mouth stricture again and their voiding opened after, urethral mouth open after voiding. Maximum urinary flow rate was 14.9~36.8 mL/s, with an average of 21.13 mL/s. Conclusion Buccal mucosa and oral tongue mucosa is good substitute of urethral reconstruction, oral cavity mucous membrane forming stage or the urethra is effective method for the treatment of urethral stricture caused by LS.