To Analyze The Efficacy And Prognosis Of Urethroplasty With Lingual Mucosa In Patients With Urethral Stricture Caused By Lichen Sclerosus

Objective:To evaluate the efficacy of urethral reconstruction using lingual mucosa graft in patients with urethral stricture caused by lichen sclerosus,and to analyze the influence of preoperative variables on the surgical outcome.Methods:This study was a retrospective study.According to the inclusion criteria,a total of 57 MGLSc patients who underwent lingual mucoplasty were collected and divided into two groups,relatively unobtrusive and relatively obstructed,according to the difference in postoperative maximum urinary flow rate.Classification transformation analysis was performed at 3 months and 6 months after catheter removal.The age,duration of disease,length of stenosis,location of stenosis,history of dilation,history of circumcision,frequency of dilation,length of tongue mucosa extraction,short-term postoperative complications,duration of indwelling catheterization,maximum urine flow rate at 3 and 6 months after extubation of the enrolled patients were observed for statistical analysis.Results:1.There were 7 patients(12.2%)with short-term postoperative complications,including urethral spasm,urinary exosmosis,and incision infection.There were 28 patients(49.1%)with history of urethral2.3 months after micturition relative flow and relative obstruction in patients in the narrow length(Z = 2.236,P = 0.025),the duration time(Z= 2.388,P = 0.017),the length of tongue mucosa(Z = 2.184,P = 0.029),merging,short-term postoperative complications(Χ 2 = 4.182,P=0.041),the results of urine flow rate analysis at 6 months after surgery showed that patients with relative patency and patients with relative obstruction had significantly higher stenosis length(Z=-4.243,P<0.001),dilation history(Χ2=7.049,P=0.008),duration of disease(Z=2.351,P=0.019),stenosis site(Χ2=18.318,P=0.001),tongue mucosa length(Z=4.257,P<0.001),Χ2=6.254,P=0.012),and χ 2=6.254,P=0.012 dilatation.In the analysis of urine flow rate at 3 months and 6 months after surgery,relative obstruction occurred in 3 cases(5.3%)and in 18cases(31.6%)at 6 months.The results of the analysis of patients with postoperative obstruction showed that 14 patients(77.8%)with postoperative obstruction symptoms 6 months had a history of urethral dilation.Conclusions:As a standard procedure,lingual mucosa urethroplasty is effective in the treatment of urethral stricture caused by MGLSc.On the basis of early diagnosis of MGLSc,attention should be paid to the changes of the patient’s condition.Topical hormone therapy can be performed in the early stage of the disease,and surgery should be performed in time when stenosis symptoms occur.The history of urethral dilatation will affect the efficacy of surgery,and urethral dilatation should be avoided as much as possible.Patients with long segment stenosis should be treated with one-stage or staged surgery,as appropriate.