- 作者：Nicolaas Lumen ; nicolaas.lumen@uzgent.be" class="auth_mail" title="E-mail the corresponding author ; Filip Poelaert ; Willem Oosterlinck ; Edward Lambert ; Karel Decaestecker ; Thomas Tailly ; Piet Hoebeke ; Anne-Franç ; oise Spinoit
- 关键词：urethral stricture ; anastomosis ; surgical ; complications ; erectile dysfunction ; recurrence
- 刊名：The Journal of Urology
- 出版年：2016
- 出版时间：December 2016
- 年：2016
- 卷：196
- 期：6
- 页码：1679-1684
- 全文大小：124 K
Materials and Methods
A total of 75 patients were treated with nontransecting anastomotic repair for short bulbar strictures in 55 and for posterior strictures in 20. Surgical morbidity was scored using the Clavien-Dindo classification at 3 months. Sexual function was measured using SHIM (Sexual Health Inventory for Men) scoring preoperatively and postoperatively. Post-void dribbling before and after nontransecting anastomotic repair was also determined. To evaluate the learning curve outcomes were evaluated in patients 1 to 25, 26 to 50 and 51 to 75.
Results
Median followup was 30 months. Stricture recurred in 6 patients (8%), all diagnosed within 7 months after nontransecting anastomotic repair. Median operative time was 95 minutes and median hospital stay was 2 days. In 61 patients (81.3%) no surgical morbidity was recorded. Five (6.7%), 6 (8%) and 3 patients (4%) experienced a grade 1, 2 and 3b complication, respectively. Seven of 32 (21.9%) and 2 of 42 evaluable patients (4.7%) reported de novo erectile dysfunction and post-void dribbling, respectively, 3 months after nontransecting anastomotic repair. No difference in outcomes was observed among the 3 patient groups.
Conclusions
Nontransecting anastomotic repair appears to be safe without a substantial learning curve effect. Patient counseling about possible surgical complications and transient erectile dysfunction is important.