Clinical analysis of female urethral diverticulum resection and reconstruction under Jacknife position

Q4 Medicine

中华泌尿外科杂志 Pub Date : 2019-12-15 DOI:10.3760/CMA.J.ISSN.1000-6702.2019.12.009

Weidong Chen, J. Xing, Ya-Huei Zeng, Fei Liu, Yuxin Chen

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引用次数: 0

Abstract

Objective To explore the clinical efficacy of female urethral diverticulum resection and reconstruction under the folding position. Methods Retrospective analysis of 22 female patients with urethral diverticulum was performed from September 2010 to December 2018. There were 12 cases of simple diverticulum, 6 cases of horseshoe diverticulum, 4 cases of circumferential diverticulum, aged from 26 to 72 years, with an average of 46.2 years, whose BMI ranged from 24.2 to 34.8 kg/m2, with an average of 30.4 kg/m2. Eleven cases (50%) presented with dysuria, 10 cases (45.5%) with repeated urinary tract infections, 7 cases (31.2%) with difficulty of voiding, 10 cases (45.5%) with urethral secretion, 9 cases (40.1%) with difficulty of sexual intercourse, and 4 cases (18.2%) without symptoms. Unlike the traditional surgical procedure under the lithotomy position, the folding position was used to expose the vagina and separate the vaginal mucosa by longitudinal incision, and the diverticulum was completely removed to the neck. The peri-operative complications and efficacy were recorded. Results All 22 cases underwent successful procedures, and were followed up for 25.2 months on average (ranged 8 to 42 months). One of them suffered from weak stream 2 months after operation, with residual urine volume of 100ml by ultrasonography. Her symptoms improved after dilatation of the urethra. Two cases suffered from different degrees of lower urinary tract storage symptoms 1 month after the operation (1 case of mild dysuria and 1 case of urinary tract infection), who improved after oral administration of levofloxacin tablets for 3-5 days. All patients had no urethral diverticulum recurrence 3 months later by ultrasonography, half a year by cystoscopy, and every six months by ultrasonography. Conclusions Surgical treatment is still the best choice for patients with urethral diverticulum. The success rate of transvaginal urethral diverticulum reconstruction with a Jackknife position is high, postoperative recurrence rate is low, and postoperative complications are few. Key words: Diverticulum; Urethra; Female; Jacknife position; Surgery

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Jacknife体位下女性尿道憩室切除重建的临床分析

目的探讨女性尿道憩室折叠位切除重建术的临床疗效。方法对2010年9月至2018年12月收治的22例女性尿道憩室患者进行回顾性分析。单纯性憩室12例，马蹄形憩室6例，环状憩室4例，年龄26～72岁，平均46.2岁，BMI 24.2～34.8kg/m2，平均30.4kg/m2。排尿困难11例（50%），反复尿路感染10例（45.5%），排尿困难7例（31.2%），尿道分泌物10例（4.55%），性交困难9例（40.1%），无症状4例（18.2%）。与传统的取石位下的手术不同，折叠位是通过纵向切口暴露阴道并分离阴道粘膜，并将憩室完全切除至颈部。记录围手术期并发症及疗效。结果22例患者均获得成功，平均随访25.2个月（8～42个月）。其中1例术后2个月出现弱流，超声检查残余尿量为100ml。尿道扩张后她的症状有所改善。2例患者术后1个月出现不同程度的下尿路积水症状（1例轻度排尿困难，1例尿路感染），口服左氧氟沙星片3～5天后症状好转。超声检查3个月后，膀胱镜检查半年后，超声检查每6个月一次，所有患者均无尿道憩室复发。结论手术治疗仍是治疗尿道憩室的最佳选择。Jackknife体位经阴道尿道憩室重建成功率高，术后复发率低，术后并发症少。关键词：憩室；尿道；女性；Jacknife位置；外科

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来源期刊

中华泌尿外科杂志 Medicine-Nephrology

CiteScore

0.10

自引率

0.00%

发文量

14180

期刊介绍： Chinese Journal of Urology (monthly) was founded in 1980. It is a publicly issued academic journal supervised by the China Association for Science and Technology and sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. This journal mainly reports on the latest scientific research results and clinical diagnosis and treatment experience in the professional field of urology at home and abroad, as well as basic theoretical research results closely related to clinical practice. The journal has columns such as treatises, abstracts of treatises, experimental studies, case reports, experience exchanges, reviews, reviews, lectures, etc. Chinese Journal of Urology has been included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences), CSCD Chinese Science Citation Database Source Journal (including extended version), and also included in American Chemical Abstracts (CA). The journal has been rated as a quality journal by the Association for Science and Technology and as an excellent journal by the Chinese Medical Association.