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目的:探讨结肠黏膜重建尿道治疗复杂性超长段尿道狭窄的应用价值与疗效。方法:对既往已有平均2.5次不成功的尿道修复史的35例患者,采用结肠黏膜一期尿道成形术,治疗其复杂性超长段尿道狭窄。所用结肠黏膜重建的尿道长10～20cm,平均14.6cm。术后分别行尿道造影,检测尿流率,部分患者行尿道镜检查。结果:患者术后随访3～60个月,平均28.5个月。31例术后排尿通畅,最大尿流率大于15ml/s。1例因结肠黏膜新尿道与前列腺部尿道吻合区血供较差,术后继发尿道狭窄;1例在术后3个月并发尿道外口狭窄,经手术矫正后排尿通畅;2例分别在术后46,20个月时发生与重建尿道无关的球膜部尿道狭窄,采用口腔黏膜尿道成形术后排尿通畅。结论:利用结肠黏膜重建尿道治疗复杂性超长段尿道狭窄或闭锁,是一种可行而有效的方法,尤其是适合在较多常规方法治疗失败者。
Objective: To investigate the value and efficacy of colonic mucosa reconstruction of urethra in the treatment of complex long segment of urethral stricture. Methods: A total of 35 patients who had an average history of urethral repairs 2.5 times unsuccessfully were treated with stage Ⅰ urethroplasty of colonic mucosa for the treatment of complicated long urethral stricture. Colon mucosa used to reconstruct the urethra length 10 ~ 20cm, an average of 14.6cm. Postoperative urography, urine flow rate, some patients underwent urethral examination. Results: The patients were followed up for 3 to 60 months, an average of 28.5 months. 31 cases of postoperative voiding, maximal uroflow rate greater than 15ml / s. One case had poor blood supply due to the anastomotic urethra of the colon mucosa and the prostatic urethra, and secondary stricture of the urethra after surgery. One case had urethral stenosis at 3 months after operation, At 46 and 20 months after operation, urethral stricture of the sphenoid part unrelated to the reconstruction of the urethra occurred and urination was smooth after oral mucosal urethroplasty. Conclusion: The use of colonic mucosa to reconstruct the urethra is a feasible and effective method for the treatment of complex long urethral stricture or atresia, especially for more conventional methods.