经尿道钬激光治疗男性尿道狭窄

Holmium Laser Urethrotomy for Male Urethral Stricture

目的：探讨经尿道钬激光治疗男性尿道狭窄的方法、安全性和疗效。方法：对38例男性尿道狭窄患者行经尿道狭窄段疤痕钬激光切除（功率10—45W），狭窄段长度：〈1．0cm者18例，1．0—1．5cm者9例，〉1．5cm者7例，完全闭锁者4例，并发膀胱结石者6例。平均最大尿流率为（5．6±2．3）ml／s。结果：36例手术成功，无大出血、尿外渗、直肠损伤等并发症发生，术后平均最大尿流率为（17．5±3．4）ml／s，2例中转开放手术，32例获随访3—18个月，其中4例行定期尿道扩张，2例以钬激光行二次手术后治愈。结论：经尿道钬激光治疗男性尿道狭窄安全、有效、创伤小、可重复治疗。

Objective： To evaluate transurethral holmium laser incision, its safety and effect in the treatment of male urethral stricture. Methods： Thirty-eight males with urethral stricture were treated by 10-45 W holmium laser urethrotomy, 18 with the stricture length shorter than 1.0 cm, 9 between 1.0 cm and 1.5 cm, 7 longer than 1.5 cm , 4 with occlusive stricture and 6 companied with bladder calculus. The average peak urinary flow rate （Qmax） was （5.6：1：2.3 ） ml/s. Results ： Successful surgery was achieved in 36 of the cases, with no complications and the average Qmax increased to （17.5：1： 3.4） ml/s. Two cases were converted to open surgery. Thirty-two cases were followed up for 3-18 months, of whom 4 received urethral dialation and 2 underwent a second holmium laser urethrotomy. Conclusion： Holmium laser urethrotomy is a safe, effective and minimally invasive therapeutic modality for male urethral stricture.