目的探讨阴茎头隧道技术联合带蒂阴茎皮瓣扩大尿道成形术治疗阴茎头尿道狭窄的临床效果。方法回顾性分析2023年1月至2024年1月就诊于上海交通大学医学院附属仁济医院泌尿外科的21例阴茎头尿道狭窄患者的临床资料,21例患者均为医源性狭窄...目的探讨阴茎头隧道技术联合带蒂阴茎皮瓣扩大尿道成形术治疗阴茎头尿道狭窄的临床效果。方法回顾性分析2023年1月至2024年1月就诊于上海交通大学医学院附属仁济医院泌尿外科的21例阴茎头尿道狭窄患者的临床资料,21例患者均为医源性狭窄(包括前列腺增生手术、经尿道膀胱病损切除术、导尿)。其中,尿道口狭窄9例,舟状窝狭窄12例。术前患者中位狭窄长度为2.00(2.00,3.00)cm,手术前后常规评估最大尿流率(_(max)imum flow rate,Q_(max))、国际前列腺症状评分(International Prostate Symptom Score,IPSS)、国际勃起功能问卷评分(International Index of Erectile Function-5,IIEF-5)。结果术后平均随访时间(8.24±2.17)个月,术后Q_(max)、IPSS分别为为21.00(19.00,26.00)ml/s、(6.86±2.29)分,高于术前6.00(4.50,8.00)ml/s、(17.24±5.68)分,差异有统计学意义(P<0.01);术后IIEF-5为21.00(10.00,22.50)分,与术前21.00(9.00,22.50)分相比,差异无统计学意义(P>0.30)。术后21例患者均无狭窄复发,阴茎头裂开,尿瘘,伤口感染、缺血坏死。结论对于尿道口及舟状窝狭窄患者,保留阴茎头完整性的阴茎头隧道阴茎皮瓣扩大尿道成形术,可实现功能与美观的统一,是疗效相对确切的方法。展开更多
BACKGROUND Urethral stricture is a condition that often develops with trauma and results in narrowing of the urethral lumen.Although endoscopic methods are mostly used in its treatment,it has high recurrence rates.The...BACKGROUND Urethral stricture is a condition that often develops with trauma and results in narrowing of the urethral lumen.Although endoscopic methods are mostly used in its treatment,it has high recurrence rates.Therefore,open urethroplasty is recommended after unsuccessful endoscopic treatments.AIM To investigate the risk factors associated with urethral stricture recurrence.METHODS The data of male patients who underwent internal urethrotomy for urethral stricture between January 2017 and January 2023 were retrospectively analyzed.Demographic data,comorbidities,preoperative haemogram,and biochemical values obtained from peripheral blood and operative data were recorded.Patients were divided into two groups in terms of recurrence development;recurrence and non-recurrence.Initially recorded data were compared between the two groups.RESULTS A total of 303 patients were included in the study.The mean age of the patients was 66.6±13.6 years.The mean duration of recurrence development was 9.63±9.84(min-max:1-39)months in the recurrence group.Recurrence did not occur in non-recurrence group throughout the follow-up period with an average time of 44.15±24.07(min-max:12-84)months.In the comparison of both groups,the presence of diabetes mellitus(DM),hypertension(HT),and multiple comorbidi-ties were significantly higher in the recurrence(+)group(P=0.038,P=0.012,P=0.013).Blood group,postoperative use of non-steroidal anti-inflammatory drugs,preoperative cystostomy,cause of stricture,iatrogenic cause of stricture,location and length of stricture,indwelling urinary cathater size and day of catheter removal did not differ between the two groups.No statistically significant difference was observed between the two groups in terms of age,uroflowmetric maximum flow rate value,hemo-gram parameters,aspartate aminotransferase(AST),alanine aminotransferase(ALT),fasting blood sugar,creati-nine,glomerular filtration rate,neutrophil-lymphocyte ratio,platelet-lymphocyte ratio,lymphocyte-monocyte ratio,monocyte-lymphocyte ratio and AST/ALT ratios.CONCLUSION In patients with urethral stricture recurrence,only the frequency of DM and HT was high,while inflammation marker levels and stricture-related parameters were similar between the groups.展开更多
目的对比组合式输尿管软镜碎石术(FURS)与微创经皮肾镜碎石术(PCNL)在上尿路结石(UUC)患者中的应用效果及对肾功能的影响。方法选取2020年1月至2022年10月新乡医学院第三附属医院收治的92例UUC患者随机分为A组、B组,各46例,B组接受PCNL,...目的对比组合式输尿管软镜碎石术(FURS)与微创经皮肾镜碎石术(PCNL)在上尿路结石(UUC)患者中的应用效果及对肾功能的影响。方法选取2020年1月至2022年10月新乡医学院第三附属医院收治的92例UUC患者随机分为A组、B组,各46例,B组接受PCNL,A组接受FURS。对比两组围手术期指标、碎石成功率、手术前后肾功能[血尿素氮(BUN)、血肌酐(Scr)、明胶酶相关脂质运载蛋白(NGAL)]、应激指标[肾上腺素(AD)、促肾上腺皮质激素(ACTH)、去甲肾上腺素(NE)]、炎症反应指标[肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)]、并发症发生率。结果A组手术耗时较B组长,术中出血量较B组少,排气及住院时间较B组短(P<0.05);术后2 d A组BUN、Scr、NGAL、AD、ACTH、NE、TNF-α、CRP、IL-6水平较B组低(P<0.05);A组并发症发生率较B组低(P<0.05)。结论FURS与PCNL在UUC中的碎石成功率相当,但FURS术中出血量较少,术后应激较小,同时对肾功能损伤较小,并发症发生率更低,更有助于患者术后恢复。展开更多
文摘目的探讨阴茎头隧道技术联合带蒂阴茎皮瓣扩大尿道成形术治疗阴茎头尿道狭窄的临床效果。方法回顾性分析2023年1月至2024年1月就诊于上海交通大学医学院附属仁济医院泌尿外科的21例阴茎头尿道狭窄患者的临床资料,21例患者均为医源性狭窄(包括前列腺增生手术、经尿道膀胱病损切除术、导尿)。其中,尿道口狭窄9例,舟状窝狭窄12例。术前患者中位狭窄长度为2.00(2.00,3.00)cm,手术前后常规评估最大尿流率(_(max)imum flow rate,Q_(max))、国际前列腺症状评分(International Prostate Symptom Score,IPSS)、国际勃起功能问卷评分(International Index of Erectile Function-5,IIEF-5)。结果术后平均随访时间(8.24±2.17)个月,术后Q_(max)、IPSS分别为为21.00(19.00,26.00)ml/s、(6.86±2.29)分,高于术前6.00(4.50,8.00)ml/s、(17.24±5.68)分,差异有统计学意义(P<0.01);术后IIEF-5为21.00(10.00,22.50)分,与术前21.00(9.00,22.50)分相比,差异无统计学意义(P>0.30)。术后21例患者均无狭窄复发,阴茎头裂开,尿瘘,伤口感染、缺血坏死。结论对于尿道口及舟状窝狭窄患者,保留阴茎头完整性的阴茎头隧道阴茎皮瓣扩大尿道成形术,可实现功能与美观的统一,是疗效相对确切的方法。
文摘BACKGROUND Urethral stricture is a condition that often develops with trauma and results in narrowing of the urethral lumen.Although endoscopic methods are mostly used in its treatment,it has high recurrence rates.Therefore,open urethroplasty is recommended after unsuccessful endoscopic treatments.AIM To investigate the risk factors associated with urethral stricture recurrence.METHODS The data of male patients who underwent internal urethrotomy for urethral stricture between January 2017 and January 2023 were retrospectively analyzed.Demographic data,comorbidities,preoperative haemogram,and biochemical values obtained from peripheral blood and operative data were recorded.Patients were divided into two groups in terms of recurrence development;recurrence and non-recurrence.Initially recorded data were compared between the two groups.RESULTS A total of 303 patients were included in the study.The mean age of the patients was 66.6±13.6 years.The mean duration of recurrence development was 9.63±9.84(min-max:1-39)months in the recurrence group.Recurrence did not occur in non-recurrence group throughout the follow-up period with an average time of 44.15±24.07(min-max:12-84)months.In the comparison of both groups,the presence of diabetes mellitus(DM),hypertension(HT),and multiple comorbidi-ties were significantly higher in the recurrence(+)group(P=0.038,P=0.012,P=0.013).Blood group,postoperative use of non-steroidal anti-inflammatory drugs,preoperative cystostomy,cause of stricture,iatrogenic cause of stricture,location and length of stricture,indwelling urinary cathater size and day of catheter removal did not differ between the two groups.No statistically significant difference was observed between the two groups in terms of age,uroflowmetric maximum flow rate value,hemo-gram parameters,aspartate aminotransferase(AST),alanine aminotransferase(ALT),fasting blood sugar,creati-nine,glomerular filtration rate,neutrophil-lymphocyte ratio,platelet-lymphocyte ratio,lymphocyte-monocyte ratio,monocyte-lymphocyte ratio and AST/ALT ratios.CONCLUSION In patients with urethral stricture recurrence,only the frequency of DM and HT was high,while inflammation marker levels and stricture-related parameters were similar between the groups.
文摘目的对比组合式输尿管软镜碎石术(FURS)与微创经皮肾镜碎石术(PCNL)在上尿路结石(UUC)患者中的应用效果及对肾功能的影响。方法选取2020年1月至2022年10月新乡医学院第三附属医院收治的92例UUC患者随机分为A组、B组,各46例,B组接受PCNL,A组接受FURS。对比两组围手术期指标、碎石成功率、手术前后肾功能[血尿素氮(BUN)、血肌酐(Scr)、明胶酶相关脂质运载蛋白(NGAL)]、应激指标[肾上腺素(AD)、促肾上腺皮质激素(ACTH)、去甲肾上腺素(NE)]、炎症反应指标[肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)]、并发症发生率。结果A组手术耗时较B组长,术中出血量较B组少,排气及住院时间较B组短(P<0.05);术后2 d A组BUN、Scr、NGAL、AD、ACTH、NE、TNF-α、CRP、IL-6水平较B组低(P<0.05);A组并发症发生率较B组低(P<0.05)。结论FURS与PCNL在UUC中的碎石成功率相当,但FURS术中出血量较少,术后应激较小,同时对肾功能损伤较小,并发症发生率更低,更有助于患者术后恢复。
