评估既往尿道扩张或DVIU对前尿道成形术结果的影响。

Tanzeel Gazder, Kanwal Naz, Vikram Seetlani, Syed Rabiullah, Usman Qamar, Mazahir Zulfiqar, Hamza Akhter, Saeed Abdi, Manzoor Hussain
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引用次数: 0

摘要

背景:男性尿道狭窄一直是泌尿外科的主要问题。出现尿道狭窄疾病的患者通常通过扩张、DVIU和尿道成形术来治疗。方法:这是一项描述性研究,研究对象是在2021年8月5日至2022年2月25日期间接受前路尿道成形术的男性患者。我们分析了尿道成形术后狭窄的年龄、持续时间、类型、长度、位置和手术治疗结果。术后3周拔除导管,建议采用UFM。分别于第1周、第6周、第3个月用尿流法测定Qmax(最大流量)> 15 ml/sec。最终成功的结果通过尿流术评估。治疗3个月后尿流量大于15mL/s即为成功。结果:在我们的研究中,A组和B组患者的失血量,既往有过DVIU或扩张的患者术中出血多于无手术史的患者。B组患者出血200 ~ 500 ml占66.67%,高于A组患者。在我们的研究中,我们发现,无论患者在尿道成形术前是否接受过手术,UFM的结果都非常相似,A组96.69%的患者UFM大于15 ml/sec, B组87.88%的患者UFM大于15 ml/sec。结论:尿道扩张或DVIU延迟了最终治疗,增加了手术难度,增加了狭窄的长度、粘连和纤维化,但对尿道成形术成功的结果影响很小。
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To assess the impact of prior urethral dilatation or DVIU on the outcome of anterior urethroplasty.
Background: Male urethral stricture has remained the major problem in urologic practice. Patients presenting with urethral stricture disease are commonly managed by dilatation, DVIU, and urethroplasty. Methodology: This is a descriptive study of male patients who underwent anterior urethroplasty at our setup from 5th August 2021 to 25th February 2022. We analyzed the age, duration, type, length, and location of the stricture and the surgical treatment outcome after urethroplasty. The post-operative catheter was removed after 3 weeks, and UFM is advised. Qmax (max flow rate) > 15 ml/sec was measured on UFM (uroflowmetry) on the 1st week, 6 weeks, and followed on 3 months. Final outcome in terms of success was assessed by uroflowmetry. A maximum urine flow greater than 15mL/s after 3 months’ treatment assessed by uroflowmetry was considered as success. Results: In our study, the blood loss in group A and group B patients, those patients who had DVIU or dilation in the past, had more bleeding during surgery than those who did not have a history of surgery. 66.67% of group B patients have bleeding from 200 ml to 500 ml, which is higher than group A patients. In our study, we found that if the patient had undergone surgery or no surgery had taken place before urethroplasty, the results in terms of UFM were quite similar, as in group A, 96.69% of patients had UFM more than 15 ml/sec, and in group B 87.88% had UFM more than 15 ml/sec. Conclusion: Urethral dilatation or DVIU delays definitive treatment and increases operative challenges by increasing the length of stricture, more adhesion, and more fibrosis but has minimal impact on the outcome of urethroplasty success.
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