Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Kısa Segment Bulbar Üretral Darlıklarda Primer Anastomoz ile Bukkal Mukozal Greft Kullanılarak Ögmentasyon Cerrahilerinin Karşılaştırılması: Retrospektif Klinik Çalışma
Comparison of Primary Anastomosis and Buccal Mucosal Graft Augmentation Surgery in Patients with Short Bulbar Urethral Strictures: Retrospective Clinical Research
Ahmet TAHRAa, Resul SOBAYa, Eyüp Veli KÜÇÜKa
aSağlık Bilimleri Üniversitesi Ümraniye Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, İstanbul, TÜRKİYE
J Reconstr Urol. 2021;11(3):134-9
doi: 10.5336/urology.2021-86014
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmada, kısa segment bulbar üretral darlık nedeniyle tam kat eksizyon ile anastomotik üretroplasti uygulanan hastalar ve bukkal mukozal greft ile ögmentasyon uygulanan hastaların cerrahi sonuçlarını karşılaştırmak amaçlandı. Gereç ve Yöntemler: Kasım 2016-Mart 2020 tarihleri arasında üretroplasti uygulanan erkek hastalar, retrospektif olarak değerlendirildi. Bulbar üretrada 3 cm ve altında izole üretral darlık nedeniyle opere edilen hastalar çalışmaya dâhil edildi. Hastalar, anastomotik üretroplasti ve bukkal mukozal greft ile üretroplasti olarak 2 gruba ayrıldı. Yaş, beden kitle indeksi (BKİ), preoperatif internal üretrotomi sayıları, darlık uzunlukları, preoperatif azami akış hızları, ameliyat süreleri, postoperatif azami akış hızları, başarı oranları ve komplikasyonları karşılaştırıldı. Bulgular: Hastaların medyan yaşı 56 (36-71), medyan BKİ 26 (23,4-32,4) kg/m² olarak belirlendi. Anastomotik üretroplasti grubunda 10 hasta ve ögmentasyon grubunda 11 hasta çalışmaya dâhil edildi. Her iki grupta yaş, BKİ, internal üretrotomi sayısı, darlık uzunluğu açısından fark olmadığı gözlendi. Anastomoz grubunda başarı %80 olarak belirlenirken, ögmentasyon grubunda %81 idi ve her iki grupta cerrahi başarı benzer idi (p=0,91). Medyan 28 (13-54) aylık takip süresince nükssüz sağkalımın her iki grupta benzer olduğu gözlendi (log-rank: 0,254). Sonuç: Kısa segment bulbar üretral darlıklarda tam kat eksizyon ile anastomoz ve ögmentasyon üretroplasti tedavileri etkin ve güvenilir tedavilerdir.

Anahtar Kelimeler: Üretra darlığı; anastomoz-cerrahi; ağız mukozası
ABSTRACT
 Objective: In this study, we aimed to compare surgical results of the patients who underwent anastomotic urethroplasty surgery and augmentation with buccal mucosal graft surgery due to short bulbar urethral stricture. Material and Methods: Male patients who had urethral stricture less than or equal to 3 cm in the bulbar urethra and underwent urethroplasty between November 2016 and March 2020 were included in the study, retrospectively. The patients were evaluated in 2 groups as anastomotic urethroplasty and urethroplasty with buccal mucosal graft according to the surgical method. Age, body mass index (BMI), the previous number of internal urethrotomy, length of the stricture, preoperative maximum flow rates, time for surgery, postoperative maximum flow rates, success rates and complications were compared. Results: The median age was 56 (36-71) years and the median BMI was 26 (23.4-32.4) kg/m². Ten patients underwent anastomotic urethroplasty and 11 patients underwent augmentation. There was no difference between groups in terms of age, BMI, number of internal urethrotomy, and length of stricture. The success rate was 80% in the anastomosis group and 81% in the aug- mentation group, and it was similar in both groups (p=0.91). During median 28 (13-54) months follow-up, recurrence-free survival was similar in both groups (log-rank: 0.254). Conclusion: Transecting anastomosis and augmentation urethroplasty treatments both seem to be safe and effective methods for short bulbar urethral stricture.

Keywords: Urethral stricture; anastomosis-surgical; mouth mucosa
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