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首页> 美国卫生研究院文献>Journal of Clinical Medicine >Novel Treatment Strategy for Management of Traumatic Bulbar Urethral Rupture Using Temporary Urethral Stent after Primary Realignment; Retrospective Comparison between Thermo-Expandable Urethral Stent and Self-Expandable Polymer-Coated Urethral Stent
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Novel Treatment Strategy for Management of Traumatic Bulbar Urethral Rupture Using Temporary Urethral Stent after Primary Realignment; Retrospective Comparison between Thermo-Expandable Urethral Stent and Self-Expandable Polymer-Coated Urethral Stent

机译：初次手术后使用临时性尿道支架治疗创伤性球囊性尿道破裂的新治疗策略;热膨胀型尿道支架与自膨胀型聚合物涂层尿道支架的回顾性比较

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A variety of retrievable and other types of temporarily placed stents are currently being used. However, only a few studies have considered primary endoscopic realignment with temporary urethral stent insertion in the event of traumatic bulbar urethral injury. We aimed to compare the clinical effectiveness and complications between thermo-expandable urethral stents and polymer-coated bulbar urethral stents (BUSs) for the treatment of traumatic bulbar urethral strictures. Between September 2011 and March 2018, 30 patients who had been diagnosed with complete bulbar urethral rupture following blunt trauma underwent temporary urethral stent placement after primary realignment. Thermo-expandable nickel-titanium alloy urethral stents were placed for 15 patients (group M), and retrievable self-expandable polymer-coated BUSs were placed for another 15 patients (group A). All stents were removed within 6 months after placement. The complications and maintained patency rates were compared between the two groups. The mean stent indwelling period was 5.0 ± 2.5 months in group M and 4.9 ± 4.0 months in group A. Both groups maintained high patency rates (Group M 12/15 (80.0%) and group A 13/15 (86.7%)). Five patients who developed urethral stricture underwent direct visual internal urethrotomy (DVIU), and no patients required repeat DVIU or open surgical urethroplasty. Both groups maintained the mean maximal urinary flow rate (Qmax) at 12 months after stent removal. Discomfort (46.7% vs. 6.7%), granulation tissue formation (73.3% vs. 26.7%) and post-void dribbling (80.0% vs. 20.0%) were more frequent in group M than in group A ( = 0.013, = 0.011 and = 0.001, respectively). In conclusion, both stents were effective for managing traumatic complete bulbar urethral rupture after primary realignment. However, the thermo-expandable urethral stents had a higher complication rate while the stent was in situ than the BUSs.
机译：当前正在使用各种可取回的和其他类型的临时放置的支架。然而，只有少数研究考虑了在发生外延性球根型尿道损伤的情况下，原发性内镜下再行尿道支架置入术。我们旨在比较热膨胀型尿道支架与聚合物涂层球根型尿道支架（BUSs）在治疗外延性球根型尿道狭窄中的临床疗效和并发症。在2011年9月至2018年3月之间，对30例钝性创伤后被诊断为完全延髓性尿道破裂的患者进行了一次初次对齐后临时放置了尿道支架。 15位患者（M组）放置了热膨胀镍钛合金尿道支架，另外15位患者（A组）放置了可收回的自膨胀聚合物涂层BUSs。放置后6个月内将所有支架取出。比较两组的并发症和维持通畅率。 M组的平均支架留置期为5.0±2.5个月，A组的平均留置期为4.9±4.0个月。两组的通畅率均保持较高（M组为12/15（80.0％），A组为13/15（86.7％））。五名发生尿道狭窄的患者接受了直接视觉内尿道切开术（DVIU），并且没有患者需要重复DVIU或开放性尿道成形术。两组在移除支架后12个月均维持最大尿流率（Qmax）。 M组的不适感（46.7％vs. 6.7％），肉芽组织形成（73.3％vs. 26.7％）和排尿后的运球（80.0％vs. 20.0％）比A组更常见（= 0.013，= 0.011）和分别为0.001）。综上所述，两种支架均可有效治疗初次手术后创伤性完全性延髓性尿道破裂。但是，热膨胀型尿道支架置入原位时的并发症发生率高于BUSs。

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