联合应用两种材料治疗长段前尿道狭窄12例临床分析

Clinical analysis of 12 cases of long-segment anterior urethral stricture treated with two kinds of materials

[背景]观察带蒂包皮瓣联合带蒂睾丸鞘膜治疗长段前尿道狭窄的临床疗效.[病例报告]选择2009年1月至2017年5月间接受带蒂包皮瓣联合带蒂睾丸鞘膜治疗的长段前尿道狭窄的12例患者的临床资料进行分析,比较术前及术后的最大尿流率(Qmax)及国际勃起功能评分(IIEF-5).12例患者手术均顺利完成,术后1例发生暂时性尿漏,给予对症治疗后痊愈.术前和术后3个月平均Qmax间差异有统计学意义(P<0.05),而术后3个月和术后1年平均Qmax间差异无统计学意义(P>0.05);术前与术后3个月及术后1年的IIEF-5评分间差异均无统计学意义(P>0.05).[讨论]带蒂包皮瓣联合带蒂睾丸鞘膜治疗长段前尿道狭窄成功率较高,并发症较少.

BACKGROUND To observe the clinical efficacy of pedicled preputial skin flap combined with pedicled tunica vaginalis in the treatment of long-segment anterior urethral stricture.CASE REPORTS The clinical data of 12 patients with long-segment anterior urethral stricture treated with pedicled preputial skin flap combined with pedicled tunica vaginalis between January 2009 and May 2017 were analyzed.The Qmax and IIEF-5 before and after surgery were compared.All the 12 patients completed the surgery successfully,and 1 patient had temporary urinary leakage after the surgery,and recovered after symptomatic treatment.The difference of average Qmax before and 3 months after surgery was statistically significant（P〈0.05）,however,there was no statistically significant difference between the average Qmax at 3 months after surgery and 1 year after surgery（P〉0.05）,and there was no statistical difference between IIEF-5 before surgery and 3 months after surgery and1 year after surgery（P〉0.05）.DISCUSSION The success rate of treatment of long-segment anterior urethral stricture with pedicled preputial skin flap combined with pedicled tunica vaginalis was higher and the complications were less.