Clinical outcome of urethroplasty using free mucosal grafts for the treatment of urethral stricturecaused by lichen sclerosus
10.3760/cma.j.issn.1000-6702.2011.11.004
- VernacularTitle:游离黏膜尿道成形治疗硬化性苔藓样病所致尿道狭窄的疗效观察
- Author:
Yuemin XU
;
Qiang FU
;
Yinglong SA
;
Jiong ZHANG
;
Chongrui JIN
;
Lujie SONG
- Publication Type:Journal Article
- Keywords:
Lichen sclerosus et atrophicus;
Balanitis xerotica obliterans;
Urethral stricture;
Free mucosa;
Urethroplasty
- From:
Chinese Journal of Urology
2011;32(11):732-735
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo improve the recognition of lichen sclerosus (LS) involving the anterior urethral strictures and to investigate the outcome of urethroplasty using free mucosal grafts for the treatment of urethral strictures caused by LS. MethodsFrom January 2007 to December 2010,36 patients with anterior urethral strictures caused by LS were treated using oral mucosal grafts or colonic urethroplasty.The mean age was 41 years (range,27 -75) and the mean anterior urethral stricture length was 11.5 cm (range,5.0 -20.0 cm).Of the 36 patients,27 patients underwent dorsal lingual mucosal graft or combined buccal mucosal graft urethrography.Eight patients underwent colonic mucosal urethrography according to the length and seriousness of urethral strictures,and the remaining patient underwent anterior urethral split.Biopsies were taken from the glans,urethral meatus and urethra before urethroplasty. ResultsThe urethral silicone stent was removed 21 d post-operatively and all the patients voided well.An epithelial-stromal lesion characterized by hyperkeratosis,thinned epithelium and diffuse perivascular lymphocyte infiltrate was seen upon histological examination of the biopsied areas.The mean follow-up was 22 ( range,6 - 50) months post-operatively.Meatal stenosis developed in 2 patients undergoing oral mucosas urethroplasty and 1 patient with colonic urethroplasty,the patients voided very well after re-operation.The other patients voided well and the urinary peak flow rates ranged from 17.2 to 47.0 mL/s ( mean,23.4). ConclusionsFree mucosal grafts urethroplasty can obtain good results for the treatment of urethral strictures caused by LS.But there is a risk of recurrence of urethral stricture and closing follow-up is required,especially for meatal stenosis.
