男性尿道狭窄或闭锁的手术治疗:单中心3年回顾性研究

Surgical treatment of male urethral stricture oratresia:a single-center retrospective study

目的探讨男性尿道狭窄或闭锁的外科治疗策略,并回顾性总结不同手术方式的疗效。方法回顾性分析2015年3月至2018年3月于吉林大学中日联谊医院泌尿外科诊治的173例男性尿道狭窄或闭锁的临床资料,包括病因、狭窄部位与长度、手术方式及疗效等。结果 173例尿道狭窄患者手术均顺利完成,其中83例行狭窄段切除端-端吻合术,再狭窄10例,占比12.04%;77例行舌黏膜移植尿道成形术,再狭窄8例,占比10.38%;5例行S形尿道扩张术,再狭窄1例,占比20%;8例行经尿道钬激光内切开术,无再狭窄。结论尿道吻合术作为治疗创伤后球膜部尿道狭窄或闭锁的金标准,疗效肯定;舌黏膜移植尿道成形术可应用于各种类型的前尿道狭窄的修复重建,临床值得推广;部分患者可将腔内手术或S形尿道扩张术作为替代治疗。

Objective To explore the surgical strategies for male urethral stricture or atresia,and to summarize the efficacy of different surgical approaches.Methods The clinical data of 173 male urethral strictures or atresia diagnosed in our hospital during March 2015 and March 2018 were retrospectively analyzed,including etiology,stenosis and length,surgical procedure and efficacy.Results The operation of 173 patients with urethral stricture was successfully completed.Among them, 83 cases underwent end-to-end anastomosis, with 10 cases of restenosis, accounting for 12.04%;77 cases underwent tongue mucosa transplantation for urethroplasty, with 8 cases of restenosis, accounting for 10.38%;5 cases underwent S-shaped urethral dilatation, with 1 case of restenosis, accounting for 20%;8 cases underwent transurethral holmium laser incision, without restenosis. Conclusions Urethral anastomosis as a gold standard in the treatment of posterior urethral stricture or bulbus stricture has affirmative curative effects.Tongue mucosa transplantation for urethroplasty can be applied to the repair and reconstruction of various types of anterior urethral stricture.Intraluminal surgery or S-shaped urethral dilation can be selected as an alternative treatment for some patients.