阴茎头硬化性苔藓样变及并发前尿道狭窄的临床分析

目的：提高对阴茎头硬化性苔藓样变（LS）及由此引起的前尿道狭窄的认识，并探讨合理的手术治疗方法。方法：15例LS并发前尿道狭窄的患者，年龄27～75岁，尿道狭窄段长4～16cm。采用舌黏膜尿道成形11例、结肠黏膜尿道成形2例；尿道外口切开及前尿道劈开术各1例。所有患者手术同时行LS病变组织病理学检查。结果：术后随访6～12个月（平均10．07个月）。1例游离结肠黏膜尿道成形患者术后2月发生尿道外口狭窄。行尿道外口切开后排尿道通畅；余者术后排尿通畅，Qmax：17．2～32ml／s（平均18．70ml／s）。结论：采用游离黏膜尿道成形治疗LS性尿道狭窄可取得较好效果，但需密切随访病变迁延致尿道再狭窄。

Clinical Analysis of Lichen Sclerosus of the Male Genitalia and Anterior Urethra Stricture

Objective：To improve the recognition of genital lichen sclerosus（LS） and LS involving anterior urethra, and to evaluated the proper treatment of anterior urethral stricture caused by LS. Methods： 15 patients （aged from 27 75 years） of LS and anterior urethral stricture（ length 4-16 cm） were analyzed retrospectively. Of the 15 patients, dorsal lingual mucosal urethrography was underwent in 11 patients, colonic mueosal urethrography in 2. The other 2 patients underwent meatotomy and urethra splitted. All the patients underwent LS histopathologic ex amination at the same time. Results： Follow up was obtained for 6-12 months （mean, 10.07） postoperatively. One patient developed meatal stenosis in 2 month after colonic mucosal urethrography, and incised urethra, after which the patient voided well. The other patients voided well and urinary peak flow rates ranged from 17.2-32.0 ml/s （mean 18.7）. Conclusions：The urethral involvement in LS patients underwent free mucosal graft substitution urethroplasty may obtained good result, but the recurrence of urethral stricture should be highly recognized and followed-up.