Bulbar ve panüretral darlığı olan erkek hastalarda bukkal mukoza greft üretroplasti tedavisinin sonuçları

Amaç: Bulbar ve panüretral darlığı olan erkek hastalarda bukkal (yanak) mukozal greft (BMG) üretroplasti tedavi sonuçlarını sunmak ve ayrıca darlık nüksü ile ilişkili faktörleri belirlemek. Yöntem: Üretra darlığı nedeniyle BMG üretroplasti uygulanan erkek hastalar geriye dönük olarak incelendi. Başarı, maksimum işeme hızında >15mL/s ile işeme olarak tanımlandı. Darlık nüksü varsa sistoüretrografi ve üretroskopi yapıldı. Başarı oranı, darlık nüksü ve diğer komplikasyonlar analiz edildi. Bulgular: 24 erkek hasta tespit edildi. Bulbar darlık için 12 hastaya BMG üretroplasti ve panüretral darlık için 12 hastaya BMG üretroplasti uygulandı. Ortalama 18 aylık takipte başarı oranı %79 idi. Bulbar darlığı olan hastalarda başarı oranı %75, panüretral darlığı olan hastalarda ise %83 idi. Toplamda 5 hastada darlık nüksü gelişti. Darlık nüks oranı ile darlık uzunluğu arasında istatistiksel olarak anlamlı bir ilişki bulunamadı. Tüm nüksler daha önce ≥3 internal üretrotomi geçirmiş hastalarda meydana geldi. Önceki internal üretrotomi prosedürünün sayısı, darlık nüksü ile önemli ölçüde ilişkiliydi. Sonuçlar: Bukkal mukoza greft üretroplasti hem bulbar hem de panüretral darlıklarda etkili bir tedvi yöntemidir. Önceki internal üretrotomi prosedürünün sayısı, darlık nüksü ile önemli ölçüde ilişkilidir. İlk internal üretrotomi başarısızlığından sonra hastalara bukkal mukoza greft üretroplastisi önerilmelidir.

Anahtar Kelimeler:

yanak mukozası, erkek, üretra darlığı

Treatment outcomes of buccal mucosa graft urethroplasty in male patients with bulbar and panurethral strictures

Aim: To present the treatment outcomes of buccal mucosal graft (BMG) urethroplasty in male patients with bulbar and panurethral strictures and also to identify the factors associated with stricture recurrence. Methods: Male patients who underwent BMG urethroplasty for anterior urethral strictures were reviewed retrospectively. Success was defined as a voiding with >15mL/s in maximal voiding velocity. If stricture recurrence occured, cystourethrography and urethroscopy were performed. Success rate, stricture recurrence and other complications were analyzed. Results: 24 male patients were identified. 12 patients underwent BMG urethroplasty for bulbar stricture and 12 patients underwent BMG urethroplasty for panurethral stricture. Success rate was 79% at a mean 18 months follow up. Success rate was 75% in patients with bulbar stricture and 83% in patients with panurethral stricture. In total, 5 patients developed stricture recurrence. No statistically significant association was found between stricture recurrence rate and stricture length. All of the recurrences were occurred in patients who underwent ≥3 previous internal urethrotomies. The number of previous internal urethrotomy procedure was significantly associated with stricture recurrence. Conclusion: Buccal mucosa graft urethroplasty is effective in both bulbar and panurethral strictures. The number of previous internal urethrotomy procedure is significantly associated with stricture recurrence. Buccal mucosa graft urethroplasty should be offered to the patients after first internal urethrotomy failure.

Keywords:

buccal mucosa, male, urethral stenosis,

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