Partial resection of the urethra is sometimes necessary in the surgical treatment of locally advanced vulvar cancer. In this study, the frequency of urinary incontinence after partial urethral resection was compared with that of patients who were treated without partial resection of the urethra. Eighteen patients with vulvar cancer encroaching or infiltrating the urethra, treated by a radical vulvectomy and partial urethrectomy, were compared with 17 patients treated by vulvectomy without partial removal of the urethra. Data on urinary incontinence pre- and postoperatively from both groups were retrospectively collected from the patient files. A questionnaire on urinary incontinence was sent to a subset of patients from both groups in order to get information on the current micturation pattern. In four out of 18 patients (22%) with a partial urethrectomy, incontinence was reported, versus two out of 17 patients (12%) in the control group (P= 0.860). Eight patients in the study group and 12 in the control group are currently alive, and all responded to the questionnaire. Two (25%) in the study group and three (25%) in the control group reported to have current symptoms of urinary incontinence. This retrospective study shows that partial resection of 1-1.5 cm of the distal urethra in addition to a radical local excision for vulvar cancer does not result in a significant increase in the frequency of urinary incontinence, compared with vulvar cancer patients without partial urethrectomy.

译文

在局部晚期外阴癌的手术治疗中,有时需要部分切除尿道。在这项研究中,将部分尿道切除术后的尿失禁频率与未部分尿道切除术的患者进行了比较。将通过根治性外阴切除术和部分尿道切除术治疗的18例外阴癌侵犯或浸润尿道的患者与17例未部分切除尿道的外阴切除术治疗的患者进行了比较。从患者档案中回顾性收集两组术前和术后尿失禁的数据。向两组患者的一部分发送了有关尿失禁的问卷,以获取有关当前排尿方式的信息。在接受部分输尿管切除术的18例患者中,有4例 (22% 例) 报告了尿失禁,而对照组的17例患者中有2例 (12% 例) 报告了尿失禁 (P = 0.860)。研究组的8名患者和对照组的12名患者目前还活着,并且都对问卷进行了答复。研究组中有两个 (25%) 和对照组中有三个 (25%) 报告有尿失禁的当前症状。这项回顾性研究表明,与没有部分尿道切除术的外阴癌患者相比,除了根治性局部切除外阴癌外,部分切除1-1.5厘米远端尿道不会导致尿失禁的频率显着增加。

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