Aldehyde free - Bovine Pericardium - A New Option of Graft in Urethral Stricture Treatment.

IF 3.1 3区 医学 Q1 UROLOGY & NEPHROLOGY
Luciano A Favorito, Rodrigo R Vieiralves, Arthur V Batista, Renata Palopoli Silva, Luis Octavio Hauschild, Lucas A M Uneda, José A D Resende
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引用次数: 0

Abstract

Objective: The current management for complex urethral strictures commonly uses open reconstruction with buccal mucosa urethroplasty. However, there are multiple situations whereby buccal mucosa is inadequate (pan-urethral stricture or prior buccal harvest) or inappropriate for utilization (heavy tobacco use or oral radiation). Multiple options exist for use as alternatives or adjuncts to buccal mucosa in complex urethral strictures (injectable antifibrotic agents, augmentation urethroplasty with skin flaps, lingual mucosa, bladder mucosa, colonic mucosa, and new developments in tissue engineering for urethral graft material) (1, 2). In the present video, we present a case where we used a new option of graft to treat urethral strictures: the L-Hydro® tissue treatment technology 100% aldehyde free, VIVENDI graft.

Materials and methods: The present study was approved according to the ethical standards of the hospital's institutional committee on experimentation with human beings. A 57 year-old male patient developed a urethral stricture due to prolonged use of a urinary catheter during a previous hospitalization. A cystourethrogram was performed, which revealed a stenosis of the penile urethra measuring 2.5 cm in length. Urethroplasty was proposed for the surgical treatment in this case. We used a longitudinal penile incision with a ventral sagittal urethrotomy in the penile stricture. A free VIVENDI graft was placed into the longitudinal incision in the dorsal urethra and fixed with interrupted suture as dorsal inlay. The ventral urethrotomy was closed over a 16Fr Foley catheter and the skin incision was then closed in layers. The patient will receive post-operative follow-up for 3 months for clinical assessment through symptoms, uroflowmetry, urethroscopy and residual urine volume after urination.

Results: No intraoperative or postoperative complications occurred. The patient could achieve satisfactory voiding and no complication was seen during the three-month follow-up. Four weeks after surgery, he underwent urethroscopy, which revealed a good appearance of the urethra, with no stenosis or signs of infection.

Conclusion: In the present case the use of bovine pericardium graft for the treatment of penile urethral stricture had a good result and can be an option to repair complex urethral strictures. However, the results presented require a larger population group in addition to multicenter studies with longer follow-up time to ensure the findings obtained. Available at: http://www.intbrazjurol.com.br/video-section/20249928_Vieiralves_et_al.

无醛牛心包-尿道狭窄移植的新选择。
目的:目前复杂尿道狭窄的治疗多采用开放式尿道重建联合颊粘膜尿道成形术。然而,有多种情况下,口腔黏膜不足(泛尿道狭窄或先前的口腔收获)或不适合利用(重度烟草使用或口腔辐射)。在复杂的尿道狭窄中,有多种选择作为颊粘膜的替代品或辅助物(可注射抗纤维化药物,用皮瓣、舌粘膜、膀胱粘膜、结肠粘膜增强尿道成形术,以及尿道移植材料组织工程的新进展)(1,2)。在本视频中,我们介绍了一个病例,我们使用了一种新的移植选择来治疗尿道狭窄:L-Hydro®组织处理技术100%无醛,VIVENDI移植物。材料和方法:本研究根据医院人体实验机构委员会的伦理标准获得批准。一名57岁男性患者因先前住院期间长期使用导尿管而发生尿道狭窄。膀胱尿道造影显示阴茎尿道狭窄,长度为2.5 cm。尿道成形术被建议作为手术治疗。我们使用阴茎纵向切口和腹侧矢状尿道切开术治疗阴茎狭窄。将游离的VIVENDI移植物置入尿道背侧纵向切口,以间断缝线固定作为背侧嵌体。腹侧尿道切开术经16Fr Foley导管闭合,皮肤切口分层闭合。术后随访3个月,通过症状、尿流仪、尿道镜及排尿后剩余尿量进行临床评估。结果:无术中、术后并发症发生。随访3个月,患者排尿效果良好,无并发症发生。术后4周,患者行尿道镜检查,发现尿道外观良好,无狭窄或感染迹象。结论:本病例采用牛心包移植治疗阴茎尿道狭窄效果良好,是修复复杂尿道狭窄的一种选择。然而,所提出的结果需要更大的人群,以及更长的随访时间的多中心研究来确保所获得的结果。可在:http://www.intbrazjurol.com.br/video-section/20249928_Vieiralves_et_al。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Braz J Urol
International Braz J Urol UROLOGY & NEPHROLOGY-
CiteScore
4.60
自引率
21.60%
发文量
246
审稿时长
6-12 weeks
期刊介绍: Information not localized
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