Experience of surgical treatment of patients with complicated stricture and obliteration of the urethra
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Abstract
The results of 1284 surgical correction of urethral stricture and its obliteration for the period 2003–2016 years in 895 patients were reviewed retrospectively. The open uretрroplasty performed in 72 (5,6%) patients with long (>2 sm) urethral strictures and its obliteration. These patients were divided into 4 groups: 1st - augmentation buccal mucosa urethroplasty – 15 (20,8%), 2nd – urethro-urethro- or urethro-prostatоanastomosis – 39 (54,2%), 3rd – substitution skin and fascial flap urethroplasty – 8 (11,1%), 4th – substitution buccal mucosa-graft urethroplasty – 10 (13,9%). The average length of strictures was in 1st gr. – 2,2±0,1 sm; 2nd gr. - 3,3±0,8 sm; 3rd gr. – 3,3±0,9 sm аnd 4th gr. – 5,3±0,8 sm. An average difficulty grades of urethra strictures in 1, 2, 3, 4 groups were: 6,2±0,3; 6,8±0,7; 6,7±0,8; 9,1±0,9 he average length of recovery period of independent urination was: 1st gr. – 19,3±07 days, 2nd gr. – 16,6±0,7, 3rd gr. – 19,4±1,6 and in 4th gr. – 17,1±1,1 days. Complications of open corrections of urethral strictures in the early recovery period (30 days) were: acute urinary retention – 4 (5,5%) observations, orhoepidydymitis – 5 (6,9%), fistula perinealis – 3 (4,2%) (Clavien II). The recurrence of urethral stricture in long-term follow-up we observed in 6 (8,3%) patients (Clavien IIIb), but erectile dysfunction – in 18 (25,0%) (Clavien II-IIIb). Good result of primary open urethroplasty noted in 65 (90,3%) patients, but bad results – in 4 (5,5%), doubtfull results – in 3 (4,2%). The overall effectiveness of primary and redo urethroplasty was – 95,6%, with a mean follow-up – 10,5±2,2 months.
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References
Русаков В.И. Хирургия мочеиспускательного канала. – М.: Медицина, 1991. – 270 с.
Мартов А.Г., Ергаков Д.В., Салюков Р.В., Фахрединов Г.А. Отдаленные результаты эндоскопического лечения стриктуры уретры // Урология. – 2007. – No 5. – С. 27–32.
Коган М.И. Стриктуры уретры у мужчин. – М.: Практическая медицина, 2010. – 136 с.
Wong S., Aboumarzouk O., Narahari R. et al. Simple urethral dilatation, endoscopic urethrotomy, and urethroplasty for urethral stricture disease in adult men/ Eur.Urol. – 2012. – Vol. 43. – P. 658–675.
Наказ МОЗ України від 15.06.2007 No 330 «Про удосконалення надання урологічної допомоги населенню України» //http://www.moz.gov.ua/ua/portal/dn_20070615_330.html
Stephen Z. Fadem, M.D., FACP, FASN Charlson Comorbidity Scoring System // http://touchcalc.com/calculators/cci_js
Шамраев С.Н., Козачихина С.И., Мельник В.В. Результат эндоскопического лечения приобретенных стриктур передних и задних отделов уретры / Питання експер.клініч.медицини. – 2013, Том 4 (Вип.17). – С. 304–314.
Шамраев С.Н., Фисталь Э.Я., Данилец Р.О. Тактика лечения электротравм наружных половых органов / Здоровье мужчины. – К., 2006. – No 2. – С. 121–124.
Greenwell T.J., Venn S.N., Mundy A.R. Changing practice in anterior urethroplasty /BJU Intern. – 1999. – Vol. 83. – P. 631–635.
Barbagli G., Romano G., Sansalone S. et al. Italian validation of the English PROM-USS-Q questionnaire in patients undergoing anterior urethroplasty/ Urologia. – 2011. – Vol. 48. – P. 98–107.
Сравнительная оценка применения различных видов открытой уретропластики при длинных стриктурах и облитерациях уретры. С.А. Возианов, И.И. Горпинченко, С.Н. Шамраев // Здоровье мужчины. – К., 2016. – No 1. – С. 78–85.
Clavien PA., Dindo P., Demartines N. Classification of surgical complication. Ann Surg. – 2004. – Vol. 240. – P. 205–213.
