Asian Journal of Urology最新文献_第4页

Initial experience with robot-assisted adrenalectomy for giant adrenal tumors 机器人辅助肾上腺切除术治疗巨大肾上腺肿瘤的初步经验

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology

Pub Date : 2024-07-01 DOI: 10.1016/j.ajur.2023.05.006

引用次数: 0

Minimally invasive reconstruction of extensive mid-lower ureteral strictures using a bilateral Boari flap 利用双侧博阿里皮瓣微创重建广泛的输尿管中下段狭窄

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology

Pub Date : 2024-07-01 DOI: 10.1016/j.ajur.2024.02.009

Objective

To describe and evaluate the technique using bilateral Boari flap ureteroneocystostomy (BBFUNC) for bilateral mid-lower ureteral strictures.

Methods

We retrospectively reviewed five patients who underwent minimally invasive BBFUNC in our institution (Union Hospital, Wuhan, China) between July 2019 and December 2021. The bilateral ureters were mobilized and transected above the stenotic segments. The bladder was isolated and incised longitudinally from the middle of the anterior wall. Then, an inverted U-shaped bladder flap was created on both sides, fixed onto the psoas tendon, and anastomosed to the ipsilateral distal normal ureter. Following double-J stenting, the Boari flaps were tubularized, and the bladder was closed with continuous sutures. The patients' perioperative data and follow-up outcomes were collected, and a descriptive statistical analysis was performed.

Results

No case converted to open surgery, and no intraoperative complication occurred. The median surgical time was 230 (range 203–294) min. The median length of the bladder flaps was 6.2 (range 4.3–10.0) cm on the left and 5.5 (range 4.7–10.5) cm on the right side. All patients had not developed recurrent ureteral stenosis during the median follow-up time of 17 (range 16–45) months and had a normal maximum flow rate after surgery. The median post-void residual was 7 (range 0–19) mL. The maximal bladder capacity was decreased in one (20%) patient.

Conclusion

The present study demonstrates that minimally invasive BBFUNC is feasible and safe in treating bilateral mid-lower ureteral strictures, and the impact on lower urinary tract function is limited.

方法我们回顾性分析了2019年7月至2021年12月期间在我院（中国武汉协和医院）接受微创BBFUNC术的5例患者。双侧输尿管被移动并在狭窄段上方横断。分离膀胱并从前壁中部纵向切开。然后，在两侧制作倒 U 形膀胱瓣，固定在腰肌腱上，并与同侧正常输尿管远端吻合。双J型支架植入术后，Boari瓣被管化，膀胱被连续缝合。收集了患者的围手术期数据和随访结果，并进行了描述性统计分析。中位手术时间为 230 分钟（203-294 分钟）。膀胱瓣的中位长度为左侧 6.2 厘米（4.3-10.0 厘米），右侧 5.5 厘米（4.7-10.5 厘米）。所有患者在中位 17 个月（16-45 个月）的随访期间均未出现复发性输尿管狭窄，术后最大流量正常。术后残余尿量中位数为 7 毫升（0-19 毫升）。结论本研究表明，微创 BBFUNC 术治疗双侧输尿管中下段狭窄是可行且安全的，对下尿路功能的影响有限。

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引用次数: 0

Description of a novel robotic early post-prostatectomy anastomotic repair technique and institutional outcomes 新型机器人前列腺切除术后早期吻合口修复技术及机构成果介绍

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology

Pub Date : 2024-07-01 DOI: 10.1016/j.ajur.2023.12.001

Objective

A vesicourethral anastomotic leak (VUAL) is a known complication following robotic-assisted radical prostatectomy. The natural history of a VUAL has been well described and is frequently managed with prolonged catheterization. With increasing emphasis on patient reported outcomes, catheter duration and VUAL are associated with significant short-term quality of life impairment. We aimed to present a case series of our robotic early post-prostatectomy anastomotic repair technique, defined as revision within 6 weeks from index surgery.

Methods

A single institution prospective database identified eleven patients with a VUAL from July 2016 to October 2022 who underwent robotic early post-prostatectomy anastomotic repair by a single surgeon. Patients were diagnosed with a VUAL on pre-operative CT urogram or CT/fluoroscopic cystogram. The primary outcome was resolution of the anastomotic leak, defined as no contrast extravasation on post-operative cystography. Secondary outcomes included post-repair catheter duration and continence on the last follow-up defined as pad(s) per day.

Results

The mean time to intervention after robotic-assisted radical prostatectomy was 21 days. Eight of the eleven (72.7%) patients had no evidence of extravasation on post-repair cystogram. The range from intervention to first cystogram was 7–20 days. The median catheter duration for those with successful intervention was 10 days. The median catheter duration for those with the leak on initial post-operative cystogram was 20 days. At a mean follow-up time of 25 months, eight (72.7%) patients reported using no pads per day, and three (27.3%) patients reported one pad per day.

Conclusion

Management of a VUAL has traditionally relied on prolonged catheter drainage and the tincture of time. As the role of robotic reconstruction has been shown to be a viable modality for management of bladder neck contracture, it is important to reconsider prior dogmas of urologic care. Our case series suggests that an early repair is safe and has a high success rate. Early robotic intervention gives providers an additional tool in aiding patient recovery.

目的膀胱尿道吻合口漏（VUAL）是机器人辅助前列腺癌根治术后的一种已知并发症。VUAL 的自然病史已被详细描述，通常通过延长导尿时间来处理。随着患者报告的结果越来越受到重视，导尿管持续时间和 VUAL 与短期生活质量的显著下降有关。我们旨在介绍我们的机器人前列腺切除术后早期吻合口修复技术的系列病例，该技术的定义是在索引手术后 6 周内进行修补。患者通过术前 CT 尿路造影或 CT/荧光膀胱造影确诊为 VUAL。主要结果是吻合口漏的解决，即术后膀胱造影无造影剂外渗。次要结果包括修复后导尿管持续时间和最后一次随访时的尿失禁情况（定义为每天垫尿）。结果机器人辅助前列腺癌根治术后的平均干预时间为21天。11 名患者中有 8 名（72.7%）在修复后的膀胱造影中没有外渗迹象。从介入治疗到首次膀胱造影的时间范围为 7-20 天。成功介入的患者导尿时间中位数为 10 天。术后首次膀胱造影出现渗漏的患者导尿时间中位数为 20 天。平均随访时间为 25 个月，8 名患者（72.7%）表示每天不使用尿垫，3 名患者（27.3%）表示每天使用一个尿垫。随着机器人重建的作用被证明是治疗膀胱颈挛缩的一种可行方式，重新考虑以前的泌尿科护理教条就显得尤为重要。我们的系列病例表明，早期修复是安全的，成功率也很高。早期机器人干预为医疗服务提供者提供了帮助患者康复的额外工具。

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引用次数: 0

A review of complications after ureteral reconstruction 输尿管重建后并发症回顾

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology

Pub Date : 2024-07-01 DOI: 10.1016/j.ajur.2024.02.007

Objective

This study aimed to provide a comprehensive overview of the complications unique to ureteral reconstruction in adults, emphasizing their presentation, diagnosis, and management in the treatment of ureteral structure disease.

Methods

This review involves an in-depth analysis of existing literature and case studies pertaining to ureteral reconstruction, with a focus on examining the range of complications that can arise post-surgery. Special attention is given to the presentation of each complication, the diagnostic process involved, and the subsequent management strategies.

Results

Ureteral reconstruction can treat ureteral stricture disease with low morbidity; however, complications, although uncommon, can have severe consequences. The most notable complications include urinary extravasation, stricture recurrence, urinary tract infections, compartment syndrome, symptomatic vesicoureteral reflux, and Boari flap necrosis. Each complication presents unique diagnostic challenges and requires specific management approaches.

Conclusion

Ureteral reconstruction is a highly effective treatment for ureteral stricture disease. Having a strong understanding of the potential complications that patients may experience following ureteral reconstruction is not only critical to adequately counsel patients but also facilitate prompt diagnosis and management of complications when they arise.

目的本研究旨在全面概述成人输尿管重建所特有的并发症，强调这些并发症在输尿管结构疾病治疗中的表现、诊断和处理方法。方法本综述深入分析了与输尿管重建相关的现有文献和病例研究，重点研究了手术后可能出现的一系列并发症。结果输尿管重建可以治疗输尿管狭窄疾病，发病率较低；但是，并发症虽然不常见，却可能造成严重后果。最显著的并发症包括尿液外渗、狭窄复发、尿路感染、隔室综合征、症状性膀胱输尿管反流和 Boari 皮瓣坏死。每种并发症都会带来独特的诊断挑战，并需要特定的处理方法。结论输尿管重建是一种非常有效的输尿管狭窄疾病治疗方法。充分了解患者在输尿管重建术后可能出现的并发症不仅对为患者提供充分的咨询至关重要，而且还有助于在出现并发症时及时诊断和处理。

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引用次数: 0

Prospective randomized study correlating intra-operative urethral mucosal injury with early period after transurethral resection of the prostate stricture urethra: A novel concept 前瞻性随机研究：术中尿道粘膜损伤与经尿道切除术后前列腺尿道狭窄的早期相关性：一个新概念

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology

Pub Date : 2024-07-01 DOI: 10.1016/j.ajur.2024.02.006

Objective

To investigate the incidence of urethral stricture during the early period after transurethral resection of the prostate (TURP) and correlate its incidence with intra-operative urethral mucosal injury during TURP. Also to compare the other established risk factors affecting the development of urethral stricture among patients undergoing monopolar or bipolar TURP over a period of 6 months follow-up as the prospective randomized study.

Methods

One hundred and fifty men older than 50 years with lower-urinary tract symptoms associated with benign prostatic hyperplasia were randomized to undergo either standard monopolar TURP with glycine as the irrigation fluid or bipolar TURP with normal saline as irrigant. The prostate size, operative time, intra-operative mucosal rupture, catheter time, catheter traction duration, uroflowmetry, and post-operative stricture rate were compared.

Results

A total of 150 patients underwent TURP, including 74 patients undergoing monopolar TURP (one patient was excluded as his post-operative histopathological examination report was of adenocarcinoma prostate) and 75 patients undergoing bipolar-TURP, all of which were performed using a 26 Fr sheath resectoscope. The mean International Prostate Symptom Score and maximum urinary flow rate score at post-operative 3 months and 6 months were comparable between the groups. Out of 149 patients, nine patients (6.0%) developed urethral stricture. The severity of the injury (urethral mucosal injury) correlated with the likelihood of developing a subsequent complication (stricture urethra). Patients with stricture had significantly larger prostate volume than patients without stricture (65.0 mL vs. 50.0 mL; p=0.030). Patients with stricture had longer operative time than patients without stricture (55.0 min vs. 40.0 min; p=0.002). In both procedures, formation of post-operative stricture urethra was independently associated with intra-operative mucosal injury.

Conclusion

Intra-operative recognition of urethral mucosal injury helps in prediction of stricture urethra formation in early post-operative period.

目的研究经尿道前列腺切除术（TURP）术后早期尿道狭窄的发生率，并将其发生率与 TURP 术中尿道粘膜损伤相关联。方法 150 名 50 岁以上、伴有良性前列腺增生症下尿路症状的男性被随机分配接受以甘氨酸为冲洗液的标准单极前列腺电切术或以生理盐水为冲洗液的双极前列腺电切术。结果共有 150 名患者接受了前列腺电切术，其中 74 名患者接受了单极前列腺电切术（一名患者因术后组织病理学检查报告为前列腺腺癌而被排除在外），75 名患者接受了双极前列腺电切术，所有手术均使用 26 Fr 鞘切除镜进行。两组患者术后 3 个月和 6 个月的平均国际前列腺症状评分和最大尿流率评分相当。在 149 名患者中，有 9 名患者（6.0%）出现尿道狭窄。损伤的严重程度（尿道粘膜损伤）与发生后续并发症（尿道狭窄）的可能性相关。有狭窄的患者前列腺体积明显大于无狭窄的患者（65.0 mL 对 50.0 mL；P=0.030）。狭窄患者的手术时间比无狭窄患者长（55.0 分钟对 40.0 分钟；P=0.002）。结论术中识别尿道粘膜损伤有助于预测术后早期尿道狭窄的形成。

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引用次数: 0

Management of ruptured renal angiomyolipoma with bilateral staghorn calculi 肾血管肌脂肪瘤破裂并伴有双侧鹿角状结石的治疗方法

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology

Pub Date : 2024-07-01 DOI: 10.1016/j.ajur.2024.01.006

引用次数: 0

Robotic reconstructive surgery: The time has arrived 机器人重建手术：时机已到

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology

Pub Date : 2024-07-01 DOI: 10.1016/j.ajur.2024.03.001

引用次数: 0

Outcomes of surgical correction of Peyronie's disease with plaque excision and grafting: Comparison of testicular tunica vaginalis graft versus bovine pericardium graft 斑块切除和移植治疗Peyronie病的疗效:睾丸阴道膜移植与牛心包移植的比较

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology

Pub Date : 2024-07-01 DOI: 10.1016/j.ajur.2023.03.005

Objective

Peyronie's disease (PD) is an abnormal wound healing in the penile tunica albuginea. After fibrotic plaque excision, different graft materials have been used to repair the defects, but the optimal graft remains unknown. This study aimed to compare the functional outcomes of testicular tunica vaginalis grafts and bovine pericardium grafts in patients with severe PD.

Methods

A retrospective comparative study was conducted on 33 PD patients undergoing partial plaque excision and grafting from September 2015 to May 2021. The patients were divided into two groups depending on the type of graft used. For 15 patients in Group B, testicular tunica vaginalis grafts were used to repair the defect, while for 18 patients in Group A, bovine pericardium grafts were used. Data of the patient's age, comorbidities, sexual function, penile curvature, postoperative complications, need for further treatment, change in penile length, and satisfaction were gathered and compared between the groups. Sexual function was evaluated using the 5-item version of the International Index of Erectile Function (IIEF-5), and a functional less than 20-degree penile curvature after surgery was considered a successful intervention.

Results

There was no difference in age, comorbidities, degree of curvature, perioperative IIEF-5, operative time, plaque size, or complication rates. After surgery, a statistically significant improvement in curvature degree (p<0.05) and satisfactory penile appearance (p<0.05) were seen in both groups without any superiority between the two groups (p=0.423 and p=0.840, respectively). With a 30-month follow-up, the IIEF-5 was consistent in both groups, with no statistical significance between the groups (p=0.492). The main change in penile length during the operation was increased and still positive in the last follow-up in both groups without statistical significance (p=0.255 and p=0.101, respectively).

Conclusion

Partial plaque excision and corporoplasty with both testicular tunica vaginalis or bovine pericardium grafts are equally effective in treating males with clinically significant PD.

目的佩罗尼氏病（PD）是阴茎白膜伤口愈合异常的一种疾病。纤维斑块切除后，不同的移植材料被用于修复缺损，但最佳的移植材料仍然未知。本研究旨在比较睾丸阴道韧带移植和牛心包移植对重度阴茎背神经损伤患者的功能疗效。方法对2015年9月至2021年5月接受部分斑块切除和移植手术的33例阴茎背神经损伤患者进行回顾性比较研究。根据使用的移植类型，患者被分为两组。B组的15名患者采用睾丸阴道韧带移植修复缺损，而A组的18名患者则采用牛心包移植修复缺损。收集了患者的年龄、合并症、性功能、阴茎弯曲度、术后并发症、是否需要进一步治疗、阴茎长度变化和满意度等数据，并在各组之间进行比较。使用国际勃起功能指数（IIEF-5）的5个项目对性功能进行评估，术后阴茎弯曲度小于20度被认为是成功的干预。术后，两组患者的阴茎弯曲度（p<0.05）和阴茎外观满意度（p<0.05）均有明显改善，但无明显优劣之分（p=0.423 和 p=0.840）。在 30 个月的随访中，两组患者的 IIEF-5 均保持一致，组间差异无统计学意义（p=0.492）。手术期间阴茎长度的主要变化有所增加，两组患者在最后一次随访时仍呈阳性，但无统计学意义（分别为 p=0.255 和 p=0.101）。

{"title":"Outcomes of surgical correction of Peyronie's disease with plaque excision and grafting: Comparison of testicular tunica vaginalis graft versus bovine pericardium graft","authors":"","doi":"10.1016/j.ajur.2023.03.005","DOIUrl":"10.1016/j.ajur.2023.03.005","url":null,"abstract":"<div><h3>Objective</h3><p>Peyronie's disease (PD) is an abnormal wound healing in the penile tunica albuginea. After fibrotic plaque excision, different graft materials have been used to repair the defects, but the optimal graft remains unknown. This study aimed to compare the functional outcomes of testicular tunica vaginalis grafts and bovine pericardium grafts in patients with severe PD.</p></div><div><h3>Methods</h3><p>A retrospective comparative study was conducted on 33 PD patients undergoing partial plaque excision and grafting from September 2015 to May 2021. The patients were divided into two groups depending on the type of graft used. For 15 patients in Group B, testicular tunica vaginalis grafts were used to repair the defect, while for 18 patients in Group A, bovine pericardium grafts were used. Data of the patient's age, comorbidities, sexual function, penile curvature, postoperative complications, need for further treatment, change in penile length, and satisfaction were gathered and compared between the groups. Sexual function was evaluated using the 5-item version of the International Index of Erectile Function (IIEF-5), and a functional less than 20-degree penile curvature after surgery was considered a successful intervention.</p></div><div><h3>Results</h3><p>There was no difference in age, comorbidities, degree of curvature, perioperative IIEF-5, operative time, plaque size, or complication rates. After surgery, a statistically significant improvement in curvature degree (<em>p</em><0.05) and satisfactory penile appearance (<em>p</em><0.05) were seen in both groups without any superiority between the two groups (<em>p</em>=0.423 and <em>p</em>=0.840, respectively). With a 30-month follow-up, the IIEF-5 was consistent in both groups, with no statistical significance between the groups (<em>p</em>=0.492). The main change in penile length during the operation was increased and still positive in the last follow-up in both groups without statistical significance (<em>p</em>=0.255 and <em>p</em>=0.101, respectively).</p></div><div><h3>Conclusion</h3><p>Partial plaque excision and corporoplasty with both testicular tunica vaginalis or bovine pericardium grafts are equally effective in treating males with clinically significant PD.</p></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 3","pages":"Pages 497-503"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214388223000760/pdfft?md5=2244b2e621c185adeab1fff228953c92&pid=1-s2.0-S2214388223000760-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43760135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Role of buccal mucosa graft ureteroplasty in the surgical management of pyeloplasty failure 颊粘膜移植输尿管成形术在肾盂成形术失败手术治疗中的作用

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology

Pub Date : 2024-07-01 DOI: 10.1016/j.ajur.2023.09.001

Matthew Lee , Elizabeth Nagoda , David Strauss , Matthew Loecher , Michael Stifelman , Lee Zhao

Objective

Secondary pyeloplasty for recurrent ureteropelvic junction obstructions may be a safe and feasible surgical option for patients. This study aimed to demonstrate outcomes of utilizing a non-transecting buccal mucosa graft ureteroplasty for management of recurrent ureteropelvic junction obstruction after prior failed pyeloplasty.

Methods

We performed a retrospective review of our Collaborative of Reconstructive Robotic Ureteral Surgery database for all consecutive patients who underwent buccal mucosa graft ureteroplasty between April 2012 and June 2022 for management of recurrent ureteropelvic junction obstructions after prior failed pyeloplasty. The primary outcome included surgical success which was defined as the absence of flank pain and no obstruction on imaging.

Results

Overall, ten patients were included in our analysis. The median stricture length was 2.5 (interquartile range [IQR] 1.8–4.0) cm. The median operative time was 230.5 (IQR 199.5–287.0) min and median estimated blood loss was 50.0 (IQR 28.8–102.5) mL. At a median follow-up of 10.3 (IQR 6.2–14.8) months, 80% of patients were surgically successful and there were no major (Clavien–Dindo Grade>2) complications.

Conclusion

Buccal mucosa graft ureteroplasty is a valuable non-transecting surgical option for patients with recurrent ureteropelvic junction obstructions who failed prior pyeloplasty and has comparable outcomes to the literature regarding standard transecting techniques.

目的针对复发性输尿管肾盂交界处梗阻的二次肾盂成形术可能是患者安全可行的手术选择。本研究旨在展示利用非横切口粘膜移植输尿管成形术治疗既往肾盂成形术失败后复发性输尿管肾盂交界处梗阻的效果。方法我们对2012年4月至2022年6月期间接受颊粘膜移植输尿管成形术治疗肾盂成形术失败后复发性输尿管肾盂交界处梗阻的所有连续患者的重建机器人输尿管手术协作数据库进行了回顾性审查。主要结果包括手术成功，即无腹部疼痛且影像学检查无梗阻。狭窄长度中位数为 2.5 厘米（四分位数间距 [IQR] 1.8-4.0）。手术时间中位数为 230.5 分钟（IQR 199.5-287.0 分钟），估计失血量中位数为 50.0 毫升（IQR 28.8-102.5 毫升）。中位随访时间为 10.3 (IQR 6.2-14.8) 个月，80% 的患者手术成功，无重大（Clavien-Dindo 2 级>）并发症。结论对于之前肾盂成形术失败的复发性输尿管肾盂交界处梗阻患者来说，颊粘膜移植输尿管成形术是一种有价值的非横断手术选择，其效果与文献中的标准横断技术相当。

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引用次数: 0

Long-term outcomes of urethral balloon dilation for anterior urethral stricture: A prospective cohort study 尿道球囊扩张术治疗前尿道狭窄的长期疗效：前瞻性队列研究

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology

Pub Date : 2024-07-01 DOI: 10.1016/j.ajur.2023.04.006

Ahmed M. Abdel Gawad , Abhijit Patil , Abhishek Singh , Arvind P. Ganpule , Ravindra B. Sabnis , Mahesh R. Desai

Objective

To prospectively follow up a cohort of anterior urethral stricture disease patients managed with balloon dilation (BD) for 3 years to evaluate the long-term outcomes and to study factors that contribute to recurrence.

Methods

This study included men who had urethral BD for significant anterior urethral stricture disease between January 2017 and March 2019. Data about the patient age, stricture characteristics, and recurrence date were recorded, along with information on postoperative indwelling catheter use and operative complications. Furthermore, information about the self-calibration procedure was collected and where available, free flow (FF) measurements during the follow-up period were recorded and analyzed. Success was defined as a lack of symptoms and acceptable FF rates (maximum flow rate>12 mL/s).

Results

The final analysis was conducted on 187 patients. The mean follow-up period was 37 months. The long-term overall success rate at the end of our study was 66.8%. Our recurrence rate was 7.4% at 12 months, 24.7% at 24 months, and reached 33.2% at the end of our study. The time to recurrence ranged from 91 days to 1635 days, with a mean of 670 days. The stricture-free survival was significantly shorter with lengthy peno-bulbar (p=0.031) and multiple strictures (p=0.015), and in the group of patients who were not committed to self-calibration protocol (p<0.011). However, post-procedural self-calibration was the most important factor that may have decreased the incidence of recurrence (odds ratio=5.85). Adjuvant self-calibration after BD not only reduced the recurrence rate from 85.4% in the non-self-calibration group to 15.1% in the self-calibration one (p<0.001), but also improved the overall stricture-free survival and FF parameters.

Conclusion

Urethral BD has a high recurrence rate in the long-term, especially with long and multiple strictures. Adjuvant self-calibration has proven to reduce the recurrence risk and the need for re-intervention.

目的对接受球囊扩张术（BD）治疗的前尿道狭窄疾病患者进行为期 3 年的前瞻性随访，以评估长期疗效，并研究导致复发的因素。方法本研究纳入了 2017 年 1 月至 2019 年 3 月间因重大前尿道狭窄疾病接受尿道 BD 治疗的男性患者。记录了患者年龄、狭窄特征和复发日期等数据，以及术后留置导尿管使用情况和手术并发症等信息。此外，还收集了有关自我校准程序的信息，并在有条件的情况下记录和分析了随访期间的自由流（FF）测量值。成功的定义是无症状和可接受的自由流速（最大流速>12 mL/s）。平均随访时间为 37 个月。研究结束时的长期总体成功率为 66.8%。我们的复发率在 12 个月时为 7.4%，24 个月时为 24.7%，研究结束时达到 33.2%。复发时间从 91 天到 1635 天不等，平均为 670 天。无狭窄存活期明显短于有较长的半球形狭窄（p=0.031）和多发性狭窄（p=0.015），以及未坚持自我校准方案的患者组（p<0.011）。然而，术后自我校准是可能降低复发率的最重要因素（几率比=5.85）。BD 术后辅助自我校准不仅将复发率从非自我校准组的 85.4% 降至自我校准组的 15.1%（p<0.001），还改善了无狭窄总生存率和 FF 参数。事实证明，辅助性自我校准可降低复发风险和再次干预的必要性。

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引用次数: 0