开放手术和内窥镜手术治疗男性尿道狭窄83例报告

Surgery therapy of urethral stricture(Report of 83 cases)

目的：总结83例男性尿道狭窄患者的手术治疗体会。方法：对54例≤1．5cm尿道狭窄者采用内窥镜技术治疗；对29例〉1．5cm尿道狭窄中的21例行开放手术治疗，其中4例长段尿道狭窄者利用包皮瓣或阴茎皮瓣做尿道成形术，另8例行内窥镜手术治疗，其中5例采用自体包皮片移植术。结果：经6～36个月随访，开放手术排尿通畅者占85．7％，内窥镜手术排尿通畅者为88．7％。结论：临床上应根据尿道狭窄范围及长短选择手术方式，尿道狭窄段≤1．5cm者适合内窥镜手术，而〉1．5cm者适合开放手术。而包皮皮片、包皮、阴茎皮瓣是非常好的长段尿道狭窄的替代物。

Objective：To summarize the surgery therapy experience of 83 patient of urethral stricture. Methods： The endoscope was used in 54 cases with the length of stricture less than 1.5 cm. The open operation was performed on 21 of 29 patients with the length of stricture over 1.5 cm, and urethroplasty with prepuce allograft or penis skin flap was performed on 4 of them. 5 of the other 8 cases received endoscope operation and got prepuce allograft. Results：The follow-up were 6 to 36 months, 85.5 % patients who received open operations can urinate easy and smooth. Nevertheless it is 89.9% in endoscope operation group. Conclnsions：The operation way is determined by the length of stricture. The endoscope is fit for patients whose length of stricture is less than 1.5 cm. When it is over 1.5 cm, the open operation is more suitable. The prepuce skin graft or the penis skin flap is a rational surrogate of long urethral stricture.