TY - JOUR A2 - 乔尔杰维茨，米罗斯拉夫AU - Shahrour，瓦利德AU - 乔希，潘卡AU - 亨特，克雷格B. AU - 巴特拉，维克拉姆S. AU - Elmansy，哈齐姆·AU - Surana，Sandesh AU - 库尔卡尼，桑杰PY - 2018DA - 2018年11月21日TI - 9137892 VL - - 2018 AB在尿道狭窄SP的评价和管理使用小口径输尿管镜的好处 - 介绍和目标。尿道狭窄的正确评价尿道重建手术计划的重要组成部分。狭窄的正确评价，可以在某些情况下是具有挑战性的，尤其是当鼻道参与。We propose that the use of a small caliber ureteroscope (4.5 Fr and 6.5 Fr) can offer additional help and use for the surgical planning in urethroplasty. 方法。我们前瞻性地收集了76例谁在库尔卡尼重建泌尿外科中心，浦那，印度和雷湾地区健康科学中心，雷湾，加拿大经历了urethroplasties数据。患者有逆行和排尿urethrograms术前行。The stricture was assessed visually using a 6.5 Fr ureteroscope. If the stricture was smaller than 6.5 Fr, we attempted using the 4.5 Fr ureteroscope. In nonobliterated strictures, we attempted bypassing the stricture making sure not to dilate the stricture. A glide wire would be passed to the bladder under vision. Stricture length, tissue quality, presence of other proximal strictures, false passages, and bladder tumors or stones would be assessed visually. If the penile stricture was near obliterative (smaller than 4.5 Fr caliber), a two-staged procedure is elected to be performed. For proximal bulbar strictures, if the urethral caliber is less than 4.5 Fr and the stricture length is less than 1 cm, we perform a nontransecting anastomotic urethroplasty (NTAU). If the stricture length is >1 cm, we perform a double-face augmented urethroplasty (DFAU). If the urethral caliber is >4.5 Fr and particularly those who are sexually active, ventral inlay with buccal mucosal grafts (BMGs) is performed. In mid to distal bulbar strictures, if the urethral caliber is >4.5 Fr, our procedure of choice is dorsal onlay with BMG. For those with urethral caliber <4.5 Fr and a stricture less than 1 cm, we perform a NTAU. For strictures longer than 1 cm, we perform a DFAU. With the exception of trauma, we very rarely transect the urethra. For panurethral strictures, we almost exclusively perform Kulkarni one-sided dissection. 结果。在76例谁提出了尿道成形术2014年七月至九月2014（浦那）和2016年4月和2017年9月（桑德贝）之间进行尿道。绕过狭窄是在68名患者（89％），而这是在8名患者（11％）不成功实现。In all unsuccessful urethroscopies, the stricture was near obliterative <4.5 Fr. Our surgical planning changed in (13) 17% of the cases. Out of 43 bulbar strictures, the decision was changed in (9) 21% where we performed 4 DFAU, 3 AAU (augmented anastomotic urethroplasty), and 2 EAU (end anastomotic urethroplasty). In 13 penile strictures, we opted for staged urethroplasty including 3 Johansons and 1 first-stage Asopa in 30.7%. In 20 panurethral urethroplasties, 1 patient (5%) had a urethral stone found in a proximal portion of the bulbar urethra distal to a stricture ring that was removed using an endoscopic grasper. 结论。使用小口径输尿管镜可以在狭窄的口径，长度和组织质量评价提供帮助。范围也可以有助于放置导丝，评价后尿道，并筛选尿道或膀胱结石。它还可以改善术前患者咨询，避免不必要的意外。SN - 1687-6369 UR - https://doi.org/10.1155/2018/9137892 DO - 10.1155 /九百一十三万七千八百九十二分之二千○十八JF - Hindawi出版KW - - 泌尿外科PB进展ER -