Transperineal anastomotic urethroplasty with distal transection versus proximal transection:How to predict?  

作　　者：Lin Wang Wenxiong Song Gong Chen Zuowei Li Rong Lyu Chongrui Jin Xuxiao Ye Yidong Liu Yinglong Sa Xiangguo Lyu 

机构地区：[1]Department of Urology,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai,China [2]Department of Urology,Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China [3]Shanghai Eastern Institute of Urologic Reconstruction,Shanghai,China

出　　处：《Current Urology》2024年第4期307-311,共5页当代泌尿学（英文）

基　　金：National Natural Science Foundation of China(grant numbers:82100707 and 82270707);Shanghai Municipal Health Commission research project(grant number:202140191).

摘　　要：Objectives To evaluate the pubourethral stump angle(PUA)to determine the site of urethral transection during transperineal anastomotic urethroplasty(TAU).Patients and methods Patients diagnosed with pelvic fracture urethral distraction defect who underwent preoperative magnetic resonance(MR)urethrography and were treated with TAU between June 2019 and December 2021 were retrospectively reviewed.According to the site of urethral transection during TAU,patients were classified into proximal and distal groups receiving TAU with proximal and distal transection,respectively.The demographic and clinical data were recorded.The PUA was measured on sagittal T2-weighted MR urethrography.The relationship between the site of urethral transection and PUA was analyzed.Results Sixty-seven patients were included.Forty-one and 26 patients were included in the proximal and distal groups,respectively.Finally,the success rates in the proximal and distal groups were 95.1%and 92.3%,respectively.The PUAs were 123.7°±14.6°and 86.5°±9.8°(p=0.005),respectively.The curves for the 2 groups intersected between 90°and 110°.The scribing effects at 90°,100°,and 110°in the 2 groups were compared in detail.Compared with 90°and 110°,100°had the highest sensitivity as the demarcation line.Conclusions In the treatment of pelvic fracture urethral distraction defect,the PUA on MR urethrography is an objective and valid parameter for evaluating the site of urethral transection during TAU.A PUA>100°indicates that proximal transection should be preferentially attempted.

关 键 词：Pelvic fracture URETHRA Anastomotic urethroplasty Magnetic resonance Urethrography 

分 类 号：R699.6[医药卫生—泌尿科学]