Exploration of the source of bacteria in the neo-urethra after anterior urethroplasty / 中华泌尿外科杂志

ABSTRACT

Objective To explore the reason that the neo-urethra infection after urethroplasty,and improve the perioperation procedures to reduce infection rate.Methods The clinical data of 62 anterior urethral stricture patients undergoing surgical treatment from July 2014 to April 2017 were analyzed.Then samples from urine,material for urethral reconstruction,urethra orifice and urethra were collected respectively.The bacterial culture,identification and pulsed field gel electrophoresis (PFGE) was performed.All the patients were males,and the mean age was 35.6 years (ranging 10-68 years).Operation methods were urethroplasty using oral mucosa in 40 cases,using penile flap in 23,using scrotal flap in 5,using penile flap combined with oral mucosa in 9,using penile flap combined with scrotal flap in 3 and using preputial flap in 1.Results The bacteria isolated from urethra orifice after operation were consistent with bacteria isolated from the neo-urethral lumen in 41 cases.There were 18 cases that shared the identical bacteria isolated from material for urethral reconstruction and neo-urethral lumen.In 7 patients,under careful isolation and identification,same bacteria were found to exist in both preoperative urethral lumen and neo-urethral lumen.Bacteria were not detected in the neo-urethral lumen in 13 cases.The bacteria isolated from urine were consistent with bacteria isolated from the neo-urethral lumen in 3 cases.Conclusions The bacteria in the neo-urethra mainly come from urethra orifice.Urine is not the main source for bacteria in neo-urethra.Perioperative intervention for sources of bacteria is an effective measure to improve the success rate of operation.