Combining Free Buccal Mucosal Graft and Local Tissue from Urethral Diverticulectomy to Repair Complex Urethral Stricture: Report of a Case

併用口腔黏膜游離皮瓣與局部尿道憩室組織以修補複雜性尿道狹窄：病例報告

唐守宏(Shou-Hung Tang) ； 高建璋(Chien-Chang Kao) ； 吳勝堂(Seng-Tang Wu) ； 莊豐賓(Feng-Ping Chuang) ； 查岱龍(Tai-Lung Cha)

《Formosan Journal of Surgery》 43卷5期 (2010/10) Pp. 243-247

https://doi.org/10.29833/FJS.201010.0005

摘要

修復複雜性尿道狹窄對所有外科醫師而言都是一個很大的挑戰，多數這一類的患者在接受開放式手術前都曾經接受過多次內視鏡手術。我們報告一位38歲男性，先前遭遇跨騎性會陰外傷並導致尿道球部狹窄。一開始狹窄段落長度僅1至2公分，但是經過超過10次內視鏡手術後，受影響的尿道段長達6公分，我們並發現有多處尿道偽通路與外傷性尿道憩室產生。
在此特殊案例中我們應用了一部份尿道憩室組織來當成新尿道的一部份，並加上患者本身的口腔黏膜來重建患者尿道。患者追蹤術後至三個月時發現輕微之縫合處窄縮，長度小於0.5公分，此局部復發性狹窄歷經一次內視鏡切開術處理，此後患者已追蹤18個月無復發。

並列摘要

The repair of a complex urethral stricture is a great challenge to all surgeons. Most patients with such a condition underwent repeated endoscopic procedures before having the definitive open repair. We describe a 38-year-old male who sustained straddle injury and subsequently developed stricture at the bulbar urethra. The affected urethral segment was 1-2 cm long in the beginning, but became 6 cm in length after more than 10 endoscopic procedures. Prior to definitive repair, we noted multiple false passages and diverticula in the urethra. In this particular case, the trauma-related urethral diverticulum was used as part of the ventral floor and the rest of the urethral lumen was reconstructed with a free buccal mucosal graft. Following the urethroplasty, a short web-like stricture (＜0.5 cm in length) developed three months after the operation. The short stricture was further managed by endoscopic internal urethrotomy only once. No recurrence was noted up to 18 months thereafter.

並列關鍵字

urethra ； stricture ； urethroplasty ； buccal mucosa ； diverticulum