Urethra rerouted under corpora cavernosus anastomotic urethroplasty for treatment of complex posterior urethral strictures
10.3760/cma.j.cn112330-20200616-00468
- VernacularTitle:尿道转位阴茎海绵体脚下吻合性尿道成形术治疗复杂性后尿道狭窄的疗效分析
- Author:
Yuemin XU
1
;
Qingbing ZHANG
;
Zizhen HOU
;
Mingjun DU
;
Xiangli YANG
;
Chao LI
;
Lujie SONG
;
Hong XIE
;
Hongbin LI
;
Tao LIANG
;
Kaile ZHANG
;
Zhenghao DAI
;
Qiang FU
Author Information
1. 上海交通大学附属第六人民医院泌尿外科 200233
- From:
Chinese Journal of Urology
2020;41(11):825-829
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the outcomes of urethra around corpora cavernosus anastomotic urethroplasty for the treatment of complex posterior urethral strictures.Methods:Between June 2008 and June 2020, 35 patients with complex posterior urethral strictures were treated using urethra rerouted under one corpora cavernosus anastomotic urethroplasty. The patients’ age was 3-54 years(mean 23.2 years), the urethral stricture or loss length was 4-7 cm(mean 5.2 cm), and 6 patients associated with urethrorectal fistula. The technique involved: ①The anterior urethra is dissected long more than 5 cm, separation of the proximal corporeal bodies, inferior pubectomy and the dissected proximal urethra.②A channel around the left crus of the penis through the inferior pubectomy is separated and urethra rerouted under left corpora cavernosus to allow a tension-free anastomosis to the proximal urethra.Results:Two patients lost follow-up; the remainder 33 patients were followed-up for 3 to 144 months(mean 37 months). Thirty-two patients could void normally(97%), The examination of maximal urinary flow rates(Q max) were taken in 21 patients, of whom Q max was 13.6-35.5 ml/s (mean 17.5 ml/s) in 7 children and 16.3-77.6 ml/s(mean 27.9 ml/s) in 14 adult patients. All 6 patients associated with urethrorectal fistula successful repaired, of these patients 1 had died of hemorrhage of brain 6 years postop. One patient developed urethral stenosis postoperatively. Continence was achieved in 29 patients, the remaining 3 patients had incontinence from mild to moderate. Conclusions:Urethra rerouted under left corpora cavernosus anastomotic urethroplasty is not only an effective surgical salvage option, with low recurrent rate for patients with complex posterior urethral strictures, but also do not cause curve and affect growth of corpora cavernosus.
