内镜下会师治疗尿道严重狭窄或闭锁（附17例报告）

Endoscopic meeting surgery for urethral severity stricture or atresia （a report of 17 cases）

目的探讨内镜下会师治疗尿道严重狭窄或闭锁的有效性与安全性。方法2002年3月-2006年12月经膀胱造瘘通道顺行与经尿道逆行内镜下会师，应用冷刀、电切镜或钬激光治疗尿道严重狭窄或闭锁17例，其中单纯尿道严重狭窄11例，合并闭锁6例。狭窄或闭锁位于后尿道12例，5例位于前尿道。尿道闭锁平均长度为1．2cm，尿道狭窄平均长度为2．3cm。结果17例患者均手术成功，6例在软膀胱镜下钬激光顺行切开尿道，11例逆行切开尿道。平均手术时间115min，留置导尿管4～6周，术后定期行尿道扩张，未见尿失禁病例，狭窄复发1例。结论内镜下会师治疗尿道狭窄或闭锁具有直观、安全、微创的特点，临床效果满意。

Objective To assess the efficacy and safety of endoscopic meeting surgery for the treatment of urethral severity stricture or atresia. Methods The eedoseopic meeting surgery via the bladder fistula and urethra retrogression applying cold knife, reseetoseope and holmium laser was performed on 17 patients with severe urethral stricture or atresia from March 2002 to December 2006. Among them 11 patients had simple severe urethral stricture,others combined with atresia, 12 eases had the disease located in the posterior urethral, others located in the anterior urethral. The average length of urethral atresia was 1.2 era, the average length of urethral stenosis was 2.3 era. Results All of the 17 cases achieved success at one session. Six eases were incised the urethral reverse using holmium laser tinder the surveillance of flexible eystoseopy, others were done reversely. The average operation time was 115 minutes,Foley catheter was left for 4 -6 weeks,urethral dilation was performed in scheduled time after the procedure, no urine incontinent was observed,recurrent urethral stenosis was found in 1 case. Conclusion The endoscopic meeting surgery is a kind of direct,safety and minimally invasive teehnlque for urethral stricture or alresia,the clinic effect is satisfied.