铥激光尿道内切开术治疗尿道狭窄37例

Transurethral thulium laser incision in treatment of urethral stricture or atresia

目的:探讨铥激光尿道内切开治疗尿道狭窄及闭锁的疗效。方法:对37例尿道狭窄或闭锁的患者行铥激光尿道狭窄处内切开术,切除局部纤维瘢痕组织,修整尿道黏膜面,使管腔光滑;尿道闭锁者先行尿道会师术。结果:所有患者手术过程均顺利,28例一次手术治愈,4例经多次尿道扩张后治愈,4例在术后3个月至1年再次尿道狭窄,行铥激光内切开后治愈,1例3次铥激光内切开手术后治愈。术后前尿道瘘1例,持续导尿后自愈。术后1个月、3个月及术后1年平均最大尿流率分别为(23.4±3.1)ml/s,(21.4±2.7)ml/s,(15.4±3.5)ml/s。结论:铥激光尿道内切开加瘢痕切除术是治疗尿道狭窄及闭锁安全、有效的治疗方法。

Objective：To evaluate transurethral thulium laser in treatment of urethral stricture or atresia.Mathods：37 patients with urethral stricture or atresia were treated through transurethral thulium laser incision, fiber cicatricial tissue was removed by thulium laser.Open urethral reconstruction was necessary for the urethral atresia.Results：37 patients undergone operation were safe during intraoperation.28 patients were cured by once operation.4 patients were treated with dilatation of urethra postoperation. Urethral stricture were recurrented in d patients,and undergone thulium laser incision therapy again.One patient were treated by thulium laser incision for 3 times. Urethral fistula in one patient was cured by continous catheterization postoperation.The maximum flow rate（MFR） was （23.4±3.1） ml/s,（21.4±2.7） ml/s,（15.4±3.5） ml/s, respectively,after operation 1 month,3 months and 12 months.Conclusion ：Transurethral thulium laser incision and fiber cicatricial tissue removed is a safe and effective therapy for urethral stricture or atresia.