Clinical efficacy of modified lingual mucosal urethral reconstruction in the treatment of urethral stricture based on propensity score matching
Objective To investigate the clinical efficacy of modified lingual mucosal urethral re-construction in the treatment of urethral stricture(US).Methods The clinical data of 112 male patients with urethral stricture treated in Xiangya Changde Hospital from January 2019 to February 2024 were retro-spectively collected by using tongue mucosa graft or pedicled penile flap.According to different graft ure-thral reconstructions,the patients were divided into observation group(n=52,lingual mucosal urethral re-construction)and control group(n=60,penile flap urethral reconstruction).The propensity score matc-hing(PSM)was used for 1∶1 matching between the two groups.Finally,41 pairs of data were successfully matched.All patients were followed up for 1 year after operation.The maximum urinary flow rate at differ-ent time points,international index of erectile function 5(IIEF-5),success rate,recurrence rate and com-plication rate of operation were compared between the two groups.Independent sample t test was used for measurement data comparison,and x2 test was used for counting data comparison.Results In observation group and control group,the maximum urinary flow rate was(22.3±3.6)ml/s and(21.8±3.7)ml/s(t=0.620,P＞0.05)at extubation after operation,(20.1±4.2)ml/s and(19.9±4.4)ml/s(t=0.210,P＞0.05)at 1 month after operation,(19.3±3.6)ml/s and(18.9±3.8)ml/s(t=0.383,P＞0.05)at 3rd month after operation,(17.7±2.4)ml/s and(17.5±2.5)ml/s(t=0.487,P＞0.05)at 6th month after operation,(16.4±1.9)ml/s and(15.8±1.9)ml/s(t=1.473,P＞0.05)at 1st year after op-eration,success rate of operation was 97.6％(40/41)and 92.7％(38/41)(x2=1.051,P＞0.05),recur-rence rates were 2.4％(1/41)and 9.8％(4/41)(x2=1.917,P＞0.05),total incidence of postoperative complications was 7.3％(3/41)and 12.2％(5/41)(P＞0.05),and postoperative IIEF-5 scores were(15.9±3.4)and(14.0±3.5)(t=2.542,P＜0.05),respectively.Conclusion Tongue mucosa is effec-tive in the treatment of patients with US during urethral reconstruction.It can effectively improve urination function and subjective urination symptoms.It has little effect on sexual function and low recurrence rate.Compared with penile flap,tongue mucosa is easy to draw and has a wide range of application.
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