经阴茎头隧道带蒂阴茎皮瓣扩大尿道成形治疗阴茎头尿道狭窄的临床效果
Clinical outcomes of augmentation urethroplasty using pedicled skin flap through glans tunnel in the treatment of glansurethral stricture
姬福浩 1王林 1赵彤 2刘毅东 1吕向国1
作者信息
- 1. 上海交通大学医学院附属仁济医院 泌尿外科,上海 20000
- 2. 焦作市人民医院 泌尿外科,河南 焦作 454000
- 折叠
摘要
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(maximum flow rate,Qmax)、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Qmax、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.
Abstract
Objective To evaluate the clinical outcomes of glans tunnel augmentation urethroplasty combined with pedicledsk in flap for the treatment of glans urethral stricture.Methods A retrospective analysis was conducted on 21 patients with glans urethral stricture treated at the Department of Urology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,from January 2023 to January 2024.All cases were iatrogenic strictures,including those caused by prostate surgery,transurethral resection of bladder tumor,and catheterization.Among them,9 cases had meatal strictures,and 12 had navicular fossa strictures,with a stricture length of 2.00(2.00,3.00)cm.Maximum flow rate(Qmax).International Prostate Symptom Score(IPSS),International Index of Erectile Function-5(I1EF-5)were assessed before and after surgeries.Results The average follow-up period was(8.24±2.17)months.Postoperative Qmax was 21.00(19.00,26.00)ml/s,IPSS was(6.86±2.29),and they were higher than 6.00(4.50,8.00)ml/s and(17.24±5.68)which before surgeries with significant differences(P＜0.01).The postoperative IIEF-5 was 21.00(10.00,22.50),which was not significantly different from the preoperative 21.00(9.00,22.50)(P＞0.30).There were no recurrences of stricture,glans dehiscence,fistula,or wound infection/ischemic necrosis among the 21 patients post operatively.Conclusion For patients with meatal and navicular fossa strictures,glans tunnel urethroplasty with pedicled skin flap provides a reliable and aesthetically pleasing solution,effectively balancing functionality and appearance.
关键词
尿道口狭窄/尿道舟状窝/带蒂皮瓣/阴茎头Key words
Meatal stenosis/Navicular fossa/Pedicled skin flap/Glans引用本文复制引用
出版年
2024
NETL
NSTL
万方数据