前尿道狭窄的外科治疗探讨(“大家泌尿网”观看手术视频)  

Sugical treatment of anterior urethral stricture

作　　者：司捷旻 撒应龙 SI Jiemin;SA Yinglong(Department of Urology,Shanghai 6th People s Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai Eastern Institute for Urological Repair and Reconstruction,Shanghai 200233,China)

机构地区：[1]上海交通大学医学院附属第六人民医院泌尿外科,上海东方泌尿修复重建研究所,上海200233

出　　处：《现代泌尿外科杂志》2024年第8期661-666,共6页Journal of Modern Urology

摘　　要：前尿道狭窄涉及多段尿道,具有病因多样、局部情况多变等特点,因此其治疗方法也有多种。前尿道狭窄常用的手术治疗方式有微创治疗、尿道成形术等,其中微创治疗包括尿道扩张和尿道内切开,尿道成形术包括游离移植物尿道成形术、带蒂皮瓣尿道成形术以及尿道端端吻合术等。即便同一种手术,采取的移植物、手术切口、补片位置等也有多种选择,手术方式的多样性给泌尿外科医生特别是非专研尿道修复重建的医生进行术前评估及术式选择带来一定困难。近年来,Kulkarni口腔黏膜尿道成形术及其改良技术在前尿道狭窄的治疗方面,疗效较好。本文在探讨前尿道狭窄的2种微创治疗和3类尿道成形术各自的优缺点与适应证的基础上,详细介绍了Kulkarni术式的关键步骤和操作体会。Anterior urethral stenosis involves multiple segments of urethra,and the etiology and local conditions are varied.There are various treatment methods,including minimally invasive treatment,urethroplasty,and so on.Minimally invasive procedures include urethral dilation and endourethrotomy.Urethroplasty includes free graft urethroplasty,pedicled flap urethroplasty,and end to end urethrostomy.There are also various options for surgical grafts,surgical incisions,and patch locations,which bring difficulties to urologists,especially those who do not specialize in urethral repair and reconstruction.In recent years,Kulkarni oral mucous urethroplasty and its modified technique have been applied to the treatment of anterior urethral stricture and achieved good results.Based on the discussion of the advantages,disadvantages and indications of two minimally invasive treatment and the three types of urethrinoplasty,this article details the key steps and surgical experience of the Kulkarni technique.

关 键 词：前尿道狭窄 修复重建 舌黏膜 移植 微创治疗 尿道成形术 Kulkarni口腔黏膜 硬化性苔藓样病变 

分 类 号：R699[医药卫生—泌尿科学]