摘要
目的 探讨利用结肠黏膜一期尿道成形术治疗复杂性超长段尿道狭窄或闭锁的应用价值与疗效。方法 2 0 0 0年 10月～ 2 0 0 3年 5月采用结肠黏膜一期尿道成形术治疗 19例复杂性超长段尿道狭窄患者。患者术前有平均 3次不成功的尿道修复史 ,用结肠黏膜重建的尿道长 10～ 17cm ,平均 13.2cm。术后随访时分别行逆行尿道造影 ,尿道镜和尿流率检查。结果 本组患者术后随访 6～ 36个月 ,平均 17个月。 1例在术后 3个月并发尿道外口狭窄 ,经手术矫正后排尿通畅 ,术后 1年随访时最大尿流率 2 8.7ml/s。另 1例在术后 14个月行尿道镜检查时发现精阜肥大 ,将肥大的精阜切除后行尿动力学检查示最大尿流率高达 4 6 .5ml/s。余 17例术后排尿通畅 ,最大尿流率大于 15ml/s。结论 利用结肠黏膜重建尿道治疗复杂性超长段尿道狭窄或闭锁是一种可行而有效的方法 ,尤其适合在较多常规方法治疗失败时实施。
Objective To investigate the feasibility of urethral reconstruction with colonic mucosa graft in the treatment of complex lengthy urethral stricture. Methods Between October 2000 and May 2003, 19 male patients with complex lengthy urethral stricture that had undergone unsuccessful urethral repair 3 times on average, aged 18～65, were treated with free graft of colonic mucosa 10 to 17 cm (mean 13.2 cm) long. The patients were followed-up for 6～36 months (17 months on average) by retrograde urethrography, urethroscopy, and uroflometry. Results Meatal stenosis that needed reoperation was developed in 1 patient 3 months postoperatively. This patient became voiding very well with a urinary peak flow of 28.7 ml per second during the follow-up of 12 months after the second operation. Hyperplasia of verumontanum was observed during urethroscopy in 1 patient 14 months postoperatively. Uroflometry examination showed a urinary peak flow of 46.5 ml/s after transurethral colliculectomy. The other 17 patients were voiding well with a urinary peak flow greater than 15 ml/s (16 to 28.5 ml/s). Conclusion Colonic mucosa graft urethroplasty is a feasible procedure for the treatment of complex lengthy urethral stricture, particularly when the more conventional options fail or are contraindicated.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2003年第24期2108-2110,共3页
National Medical Journal of China
