后尿道闭锁的腔内治疗体会

Endourethral surgery for 14 cases of urethratresia

目的探讨窥视下经尿道腔内手术治疗尿道闭锁的治疗效果。方法采用内镜直视下冷刀内切开加尿道瘢痕电切术治疗后尿道闭锁。结果14例均获得闭锁段的准确切开和瘢痕组织切除,9例拔除尿管后能自行排尿,尿线粗,Qmax均>16mL/s,随访3～12个月无尿道狭窄复发。4例术后3个月内再经3-5次尿道扩张术后排尿情况保持稳定,1例最迟于6个月后尿线保持较粗,无需再行尿道扩张术。结论内镜直视下冷刀内切开加尿道瘢痕电切术是治疗后尿道闭锁的首选方法,具有操作简单、安全、疗效好、可反复治疗及创伤小等优点。

[Objective] To evaluate the endourethral surgery for traumatic urethrostenosis and urethrateesia. [Method] We treated 14 cases of posterior urethratresia by endo-discission with cryoprobe and endoscope plus urethral scar electrocision. [Result] Atrefic segment of the 14 patients were exactly cut off and scars were removed. 9 patients coud voluntarily micturate after removing urinary canal and urinary stream was fine （Qmax〉16 mL/s）. There was no recurrence of urethrostenosis after following up 3-12 months. Micturifion status of 4 patients retained stabi-lization by 3-5 times of dilation of urethra during 3 months after operation. Urinary stream of the last patient retained relatively fine at the most after 6 months and it need not dilation of urethra. [Conclusion] Endo-discission with cryoprobe and endoscope plus urethral scar electrocision is optimal method for treating posterior urethratresia. It is operated easily, safe and with good therapeutic effect. In addition, this method can be re-applied on patient and the injury is slight.