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Management of complex urethral stricture disease: Algorithm and experience from a single institute

机译：复杂尿道狭窄疾病的处理：来自单个机构的算法和经验

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Objective: There are currently no practical guidelines regarding recurrent or complex urethral strictures in Taiwan. Furthermore a specific urological reconstruction center focusing on urethroplasties in this area is currently unavailable. In this study we aim to share the experience of our institute according to an algorithm for this disease entity.Materials and methods: From December 2007 to October 2013, adult males with complex urethral strictures were enrolled. Six different surgical techniques were used for treatment. Clinical features and outcomes were analyzed through a retrospective chart review.Results: The mean age was 39 years, with a mean follow-up period of 42 months (range, 5-76 months). An average of three sessions of previous treatments was noted. The overall primary success, requiring no further intervention, was 46%. Permanent failure occurred in one patient (2.6%). The primary success for urethroplasty in distal, penile, bulbar, posterior urethra, and in stricture with hypospadias was 100%, 40%, 83%, 29%, and 60%, respectively. From the perspective of procedure type, anterior anastomotic urethroplasty (80%) and skin-based flaps (75%) resulted in the highest success rate. Following anterior or posterior buccal mucosal graft-augmented urethroplasties, 40% of patients received additional short-term dilatations or urethrotomies.
机译：目的：目前在台湾尚无关于复发性或复杂性尿道狭窄的实用指南。此外，目前还没有专门针对该领域尿道成形术的泌尿外科重建中心。在这项研究中，我们旨在根据该疾病实体的算法分享本研究所的经验。材料和方法：从2007年12月至2013年10月，招募了具有复杂尿道狭窄的成年男性。六种不同的手术技术被用于治疗。结果：平均年龄39岁，平均随访期42个月（范围5-76个月）。记录平均三个疗程的先前治疗。无需进一步干预的总体主要成功率为46％。永久失败发生在一名患者中（2.6％）。尿道远端，阴茎，延髓，后尿道和尿道下裂狭窄的尿道成形术的主要成功率分别为100％，40％，83％，29％和60％。从手术类型的角度来看，前吻合术（80％）和皮肤皮瓣（75％）导致最高的成功率。在颊黏膜前或后移植物增强型尿道成形术之后，40％的患者接受了额外的短期扩张或尿道切开术。

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