摘要
目的评估游离阴茎皮片背侧移植联合口腔黏膜腹侧覆盖治疗前尿道狭窄的临床疗效。方法回顾性分析2018年1月至2020年7月采用游离阴茎皮片结合口腔黏膜扩大尿道成形术治疗阴茎皮肤不充裕前尿道狭窄患者18例的病例资料。正中纵行切开狭窄段尿道的腹侧和背侧,再将游离阴茎皮片修补尿道背侧缺损、游离口腔黏膜覆盖修补腹侧缺损,留置F16/18硅胶尿管4周后拔除尿管并行尿流率检查。结果18例患者术后平均随访16.6(6~31)个月,游离阴茎皮片长度为(5.9±2.0)cm,口腔黏膜(唇黏膜16例、舌黏膜2例)取材长度平均(6.4±2.0)cm。术后6个月平均最大尿流率19.8 mL/s。术后未见局部皮肤坏死、未发生任何尿瘘,1例再狭窄患者膀胱镜检查发现远端吻合口狭窄,行4次尿道扩张治疗后恢复正常排尿。结论对于局部阴茎皮肤不充裕的长段前尿道狭窄患者,联合游离阴茎皮片背侧移植和口腔黏膜腹侧覆盖是治疗其较为合适的方法。
Objective To evaluate the clinical efficacy of free penile skin grafts combined with oral mucosal ventral coverage in the treatment of anterior urethral stricture.Methods We retrospectively reviewed the clinical data of 18 patients with anterior urethral stricture treated by free penile skin grafts combined with oral mucosa during Jan.2018 and Jul.2020.All urethral stricture were located in the anterior urethra,with insufficient foreskin skin.The ventral and dorsal portions of the urethra were incised longitudinally and medially.The defect of the dorsal urethra was repaired by free penile skin flap,and the defect of the ventral urethra was repaired by free oral mucosal.The F16/18 silicone ureteral catheter was retained for 4 weeks.Results The postoperative follow-up of the patients in this study was 16.6(6-31)months,the length of free penis skin was(5.9±2.0)cm,and the average length of oral mucosa was(6.4±2.0)cm.Tongue mucosa was used in 2 cases and labial mucosa in 16 cases.The mean maximum urine flow rate was 19.8 mL/s 6 months after surgery.No urinary fistula occurred after the operation.One patient developed restenosis,and returned to normal urination after 4 regular urethral dilatation.Conclusion Single-stage repair of penile urethral stricture using combined dorsal onlay penile skin flap with ventral onlay oral mucosa grafting appears to be an excellent option to repair urethral stricture with insufficient local penile skin.
作者
吕向国
钟达川
刘毅东
卢慕峻
Lü Xiangguo;ZHONG Dachuan;LIU Yidong;LU Mujun(Department of Urology,Renji Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200127,China)
出处
《现代泌尿外科杂志》
CAS
2021年第9期731-734,共4页
Journal of Modern Urology
基金
国家自然科学基金青年项目(No.81800591)
上海市青年科技英才扬帆计划项目(No.18YF1412800)。
关键词
尿道狭窄
阴茎皮片
口腔黏膜
纤维化
阴茎皮瓣
urethral stricture
penile skin graft
oral mucosa
fibrosis
penis skin flap
