唇黏膜补片修复前尿道狭窄的疗效观察

目的 探讨应用唇黏膜补片尿道成形术治疗复杂性前尿道狭窄的有效性。方法：2004年3月～2008年9月应用自体下唇黏膜补片行尿道成形术治疗复杂性前尿道狭窄27例。尿道狭窄长度为2．0～7．0cm，平均长度3．9cm。结果：术后随访5～30个月，平均14．1个月。排尿通畅22例（81．5％），最大尿流率16．9～40．2ml／s，平均23．6ml／s；再次狭窄5例（18．5％），其中近端吻合口狭窄2例，远端吻合口狭窄2例，分别予以尿道内切开及扩张后，最大尿流率保持在15ml／s以上；1例行黏膜管状尿道成形术患者出现管腔缩窄，予以再次行口腔颊黏膜替代后排尿通畅。下唇取材部位黏膜均愈合良好，1例患者出现口周麻木并持续6个月。结论：下唇黏膜取材方便，取材后供体部位并发症少，适于用作尿道狭窄成形术的替代物。

Observation of the Treatment of Labial Mucosal Graft Urethroplasty for Anterior Urethral Strictures

Objective：To evaluate the efficacy of labial mucosal graft urethroplasty for anterior urethral strictures. Methods：From March 2004 to September 2006, 27 men with anterior urethral strictures underwent graft urethroplasty with labial mucosal graft . The length of stricture was 2.0-7.0 cm （mean 3.9 cm）. Results： Mean follow up was 14.1 months（range： 5 30 months）. The surgery was successful in 22 （81.5%） cases which the peak flow rate improved to 16.9-40.2 ml/s （mean 23.6 ml/s）. Restrictures were developed in 5 cases （18.5%）, including 2 at the distal anastomosis, 2 at the proximal anastomosis, and 1 at the whole grafted area. The 4 anastomotic site restrictures were treated with dilation or internal urethrotomy with improvement of symptoms and a peak flow rate of 15 ms/s. 1 case was coarctation of ureter cavity after mucosa urethroplasty, then replaced by la bial mucosal graft again with normal urination. Donor site of the lower lip were healed well and one case of perioral numbness last 6 months. Conclusions：The labial mucosal graft is a safe and effective graft material for urethral reconstruction with potential minor risks of donor site complications.