经尿道内切开治疗男童后尿道狭窄与闭锁

Transurethral Resection of Traumatic Strictures and Obliteration of Posterior Urethra in Boys

目的:探讨经尿道内切开治疗男童外伤性后尿道狭窄与闭锁的适应证及记忆合金支架的应用。材料与方法:53例患儿年龄4～12岁,平均7岁,狭窄35例,闭锁18例。其中切开后放置钛镍螺旋形记忆合金支架23例。结果:随访3个月～8年。未放记忆合金支架组治愈23例,好转3例,尿失禁3例,改开放手术1例;放置记忆合金支架组治愈7例,好转1例,带支架正常排尿8例,改开放手术7例。结论:本法适用于治疗短段尿道狭窄或闭锁,狭窄或闭锁段<1cm 者,不需放置记忆合金支架,1～2cm 者,放置记忆合金支架效果较好,>2cm 者不适宜内切开治疗。

Objective:This is a retrospective analysis of the results of 53 boys with traumatic stricture and obliteration of posterior urethra after transuretral resection(TUR).The indications of TUR and TUR plus Ti-Ni metal stent are discussed.Materials and Methods:Thirty-five chil- dren with urethral stricture and 18 with urethral obliteration(age 4—12 yrs,average 7 yrs)are reviewed.Of them,3 cases underwent TUR and 23 received TUR plus metal stent.They were followed up from 3 months to 8 years.Results:Among patients treated with TUR,23 cured,3 improved,3 had imcontinence and 1 converted to open surgery.For those treated with TUR plus metal stent,7 cured,1 improved,8 had normal urination with stent and 7 converted to surgery. Conclusions:TUR is indicated in short urethral stricture or obliterations,for stricture shorter than 1cm,the metal stem is not necessary.Stricture or obliteration of 1—2 cm in length would be better treated by TUR plus metal stent.An open surgery should be considered for the affected segment longer than 2 cm.