CAJ | 학술논문

目的探讨倒L形阴茎带蒂皮瓣修复复杂性长段前尿道狭窄的疗效. 方法 2008年6月至2011年11月收治男性前尿道超长段狭窄患者12例.年龄28～72岁,平均56岁.狭窄段长度8～ 14 cm,平均10 cm.病因为外伤所致3例,慢性炎症所致7例,前列腺电切术后2例.患者排尿困难病史1～9年,平均2.5年,均有尿道扩张病史,7例曾行尿道内切开手术.术中将尿道狭窄段切开至正常尿道黏膜1 cm处,取阴茎腹侧纵行并向冠状沟处横行延伸的倒L形皮瓣,5-0可吸收线将皮瓣两侧与剪开的狭窄段尿道做连续缝合,两端分别与尿道断端做间断吻合. 结果术后随访6～38个月,平均21个月.10例患者排尿通畅,最大尿流率17.0～24.5 ml/s,平均19.8 ml/s.尿道造影显示重建段尿道管腔通畅.1例出现漏尿,6个月后再次手术修补治愈；另1例术后6个月出现舟状窝处尿道狭窄,行冷刀内切开治愈. 结论倒L形阴茎带蒂皮瓣取材方便,手术操作简便,是治疗超长段尿道狭窄的较好材料.
목적 탐토도L형음경대체피판수복복잡성장단전뇨도협착적료효. 방법 2008년6월지2011년11월수치남성전뇨도초장단협착환자12례.년령28～72세,평균56세.협착단장도8～ 14 cm,평균10 cm.병인위외상소치3례,만성염증소치7례,전렬선전절술후2례.환자배뇨곤난병사1～9년,평균2.5년,균유뇨도확장병사,7례증행뇨도내절개수술.술중장뇨도협착단절개지정상뇨도점막1 cm처,취음경복측종행병향관상구처횡행연신적도L형피판,5-0가흡수선장피판량측여전개적협착단뇨도주련속봉합,량단분별여뇨도단단주간단문합. 결과 술후수방6～38개월,평균21개월.10례환자배뇨통창,최대뇨류솔17.0～24.5 ml/s,평균19.8 ml/s.뇨도조영현시중건단뇨도관강통창.1례출현루뇨,6개월후재차수술수보치유；령1례술후6개월출현주상와처뇨도협착,행냉도내절개치유. 결론 도L형음경대체피판취재방편,수술조작간편,시치료초장단뇨도협착적교호재료.
Objective To explore the therapeutic effect of using inverted L-shaped penis pedicle flap to treat complicated long segment anterior urethral stricture.Methods From June 2008 to November 2011,12 male patients with long segment anterior urethral stricture were treated in our hospital.The length of urethral stricture was from 8 cm to 14 cm (mean 10 cm).The age was from 28 to 72 years (mean 56 years).In our operation,we cut through the urethral stricture segment to the point that was 1 cm to the normal urethral mucosa.We gained the L-shaped flap from penile ventral that was longitudinal and was transverse extension to the Coronal Sulcus.Two apices of the L-shaped flap were sutured to the proximal and distal apices of the urethrotomy with 5-0 polyglactin interrupted stitches.The margins of the opened urethra were sutured to the L-shaped flap with 5-0 polyglactin running sutures.Results The patients were followed up for 6-38 months postoperatively (mean 21 months).Of the 12 cases,10 cases voided well and the urinary peak flows ranged from 17.0 to 24.5 ml/s (mean 19.8 ml/s).Urinary fistula occurred in 1 case,and the patient was cured after the second repair operation 6 months later.Only 1 case had urethral stricture in navicular fossa 6 months after the operation and was cured by cold knife incision treatment.Conclusions Inverted L-shaped penis flap is easy to get and the operation is not complicated.So inverted L-shaped penis flap is a good material in the treatment of complicated long segment anterior urethral stricture.