带蒂辜丸鞘膜补片治疗阴茎硬化性苔藓样变 >2cm 前尿道长段狭窄 90例经验

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Experience of pedicled tunica vaginalis grafts in the treatment of 9O cases of longsegment anterior urethral stricture >2 cm caused by male genital lichen sclerosus

LIU Jing，GUO Li'e，SUN Zhongzhong，WANG Wanglong （Department of Urology，First People's Hospital of Luliang City，Luliang O33Ooo，China）

ABSTRACT：ObjectiveTo summarize 20years’clinical experienceof urethroplasty with pedicled tunica vaginalis grafts in the treatment of long-segment anterior urethral stricture （>2cm ） caused by male genital lichen sclerosus（GLSc）. Methods Aretrospective studywas conductedon theclinical data of 9O patients undergoing urethroplasty with pedicled tunica vaginalis grafts in our hospital. Patients were divided into three groups according to the length of stricture： 10cm （ n=44 ），and >10cm （ n=21 ）. The surgical conditions，changes in preoperative and postoperative maximum urinary flowrate（Qmax），andimprovements intheinternational indexof erectilefunction（IEF-5）scores werecomparedamong the three groups. ResultsDuring the follow-up of 6-48 （average 22.0±2.7 ）months，88 patients exhibited unimpeded urination，with a success rate of 97.8% . Retrograde urethrography showed the urethral lumen was well-dilated，the penis was notdeformedorstrictured，and thesexual intercourse was normal.The Qmax ofthethree groups wassignificantlyimproved 2， 6 and 12 months postoperatively （ P<0.01i ，butwith no statistically significant differences among the three groups （P>0.05） ！ Similarly，the IIEF-5 scores showed no statistically significant differences among or within the groups （ P>0.05） .No serious complications occurred afteroperation.Urethral stricture occurred in2casesafteroperation，oneof which hadsmooth urinationafter holmium laser urethrotomy，and theotherachieved urination after anterior urethral incision.Conclusion Urethroplastywith pedicledtunica vaginalis graftsis suitable forthe treatmentof long-segmentanteriorurethral stricture caused by GLSc.Ithas the advantagesof high surgical sucessrate，convenient graft harvesting，simple operation，few trauma and few complications. This surgical approach is recommended for primary hospitals.

KEY WORDS：pedicled tunica vaginalis grafts；tisue flap with pedicle；urethroplasty；repair of urethral stricture；genital lichen sclerosus; long-segment anterior urethral stricture

摘要：目的总结带蒂睾丸鞘膜补片尿道成形术治疗阴茎硬化性苔藓样变（GLSc）引起的前尿道长段狭窄（狭窄段长度 >2cm ）的20年临床经验。（剩余10281字）