CAJ | 학술논문

目的评估经会阴尿道端端吻合术治疗创伤性后尿道狭窄的临床疗效.方法自2009年1月～ 2013年12月共有112例创伤性后尿道狭窄患者在本院行经会阴尿道端端吻合术,尿道狭窄长度1～ 5cm,其中复杂性后尿道狭窄48例.手术方法采用单纯尿道端端吻合术39例,阴茎海绵体中隔切开+后尿道端端吻合术73例,获完整随访1年的43例患者比较其术前、术后勃起功能情况.结果 112例均成功吻合,术后排尿通畅103例(92％),其中暂时性尿失禁6例,无永久性尿失禁;再次尿道狭窄9例,其中4例行定期尿道扩张后保持排尿良好,5例手术失败.获完整随访的43例患者中,术前及术后1年国际勃起功能指数-5(IIE F-5)评分及阴茎勃起角度对性生活的影响无显著性差异.结论经会阴尿道端端吻合术治疗男性创伤性后尿道狭窄成功率高,经充分游离,小于5cm的后尿道狭窄均能实现无张力吻合,手术本身对患者勃起功能及性生活无显著影响.
목적 평고경회음뇨도단단문합술치료창상성후뇨도협착적림상료효.방법 자2009년1월～ 2013년12월공유112례창상성후뇨도협착환자재본원행경회음뇨도단단문합술,뇨도협착장도1～ 5cm,기중복잡성후뇨도협착48례.수술방법채용단순뇨도단단문합술39례,음경해면체중격절개+후뇨도단단문합술73례,획완정수방1년적43례환자비교기술전、술후발기공능정황.결과 112례균성공문합,술후배뇨통창103례(92％),기중잠시성뇨실금6례,무영구성뇨실금;재차뇨도협착9례,기중4례행정기뇨도확장후보지배뇨량호,5례수술실패.획완정수방적43례환자중,술전급술후1년국제발기공능지수-5(IIE F-5)평분급음경발기각도대성생활적영향무현저성차이.결론 경회음뇨도단단문합술치료남성창상성후뇨도협착성공솔고,경충분유리,소우5cm적후뇨도협착균능실현무장력문합,수술본신대환자발기공능급성생활무현저영향.
Objectives To evaluate the clinical effect of transperineal urethra end-to-end anastomosis on traumatic posterior urethral stricture.Methods 112 patients of traumatic posterior urethral stricture were treated by transperineal urethra end-to-end anastomosis from Jan.2009 to Dec.2013 in our hospital.The length of stenosis was from I cm to 5cm,with 48 cases of complex posterior urethral stenosis.Transperineal urethra end-to-end anastomosis was performed:43 patients with simple perineal anastomosis;73 patients with separation of the corporeal bodies.Evaluate the erectile founction of 43 patients pre and post operation who have 1 year complete follow-up.Results All 112 patients fulfilled successful end-to-end anastomosis,103 patients(92％) voided well and 6 cases were suffered with provisionally incontinence,no permanent incontinence after operation.9 patients were suffered from urethral stricture again,and 4 of them voided well after regular dilatation postoperatively,5 cases failed.43 cases get 1 year follow up,the International Index of Ereetile Function-5 (IIEF-5) and penile erectile angle have insignificant affect to sexuality pre and post end-to-end anastomotic urethrolasty.Conclusions Transperineal urethra end-to-end anastomosis has highachievement ratio for the management of traumatic posterior urethral stenosis in male,the segment of stenosis less than 5cm can get no tension anastomose by entirely dissociate,this operation has less affection to patient's erectile function and sexual intercourse.