Abstract:

Complex urethral stricture or obliteration is always a great challenge to most urologists. It is very difficult to treat those patients suffered from panurethral stricture or obliteration (>14 cm). To patients with previous failure in urethroplasty, the strategy selection will become a dilemma. In this field, we have obtained several original achievements in recent years. Comparing with those similar investigations in the world, many creative ideas or conceptions can be concluded in our study. Firstly, we have proved that the colonic mucosa could be an alterative material for urethroplasty. Up till now, 55 patients have undergone this procedure. The mean length of stricture in those patients was 15.2 cm. The clinic results demonstrated that the colonic mucosa has several advantages, such as abundant resource, easy to harvest, strong ability of anti-infection and low contractive rate. Therefore, this material is suitable for patients with panurethral stricture (>14 cm), especially for those with previous failure in operation. Secondly, we established the new conception of treating panurethral stricture or obliteration using three stages operation. Totally, 11 cases accepted this procedure, all of them obtained satisfied results. The strategy provides a new idea to treat patients with ultra-long segment of urethral stricture and obliteration between anterior and posterior urethra. Thirdly, we firstly described the pathologic characteristics and transformation rule of urethra in patients who accepted the lingual mucosa substitution in the world. And, we have invented the new technique to harvest the large area lingual mucosa. After that, we firstly performed the clinical lingual mucosa urethroplasty in China. With the effort over 10 years, we have collected the largest database about lingual mucosa urethroplasty in the world. Fourthly, we have established the objective quantitative criteria of urethral pressure (90 cmH2O or 40-50 cmH2O over baseline) in the world, which is to evaluate the effectiveness of bulbar urethral sling procedure during the operation. After using this criterion during the operation, the operative successive rate obviously increased. The related complications could be minimized. The results were encouragement. Due to those achievements, we have obtained several first prize and second prize of provincial and ministerial scientific and technical progress rewards.

Key words: urethral stricture, urinary incontinence, colonic mucosa, oral mucosa, treatment