直视下尿道内切开术治疗男性尿道狭窄或闭锁

Long-term Result of Direct Vision Internal Urethrotomy for Male Urethral Stricture or Urethratresia

目的:报告直视下尿道内切开术治疗男性尿道狭窄或闭锁的疗效。方法:尿道狭窄或闭锁的男性患者217例,均在直视下行尿道内切开术治疗。通过填表和信访形式对排尿等情况随访。结果:随访7～67个月,平均34.8个月,175例(80.6%)手术获得成功。手术共进行1～7次,平均1.6次。结论:DVIU治疗尿道狭窄或闭锁安全有效,可作为狭窄段<2cm的首选方法;2次以上的重复治疗疗效有限。

Objective To evaluate the long- term result of urethral stricture or urethratresia treated with direct vision internal urethrotomy（DVIU）. Methods A total of 217 eases of urethral stricture or urethratresia were treated with DVIU. There were 154 cases of urethral stricture and 63 cases of urethratresia. The average length of the stricture was 1.85 cm （range from 0.5 to 4.2 cm）. Questionnaires or telephone interview were given to collect the data and infonna- tion on the history, urinary voiding, sexual function, overall satisfaction after treatment, then the data were generally an- alyzed. Results Of them internal urethmtomy was successful in 175 （80.6%）, 159 patients had a less than 2 cm stricture with a higher success rate of 88.0% than those with a stricture longer than 2 cm（ P 〈 0.01 ）. In the whole se- ties, 194 patients with single DVIU or twice had the success rates of 58.1% and 48.5% respectively（ P 〈 0.05）, 23 patients underwent three times or more of procedure with a success rate of 17.4% （ P 〈 0.01 ）. Conclusion DVIU is a safe and efficient treatment for male urethral stricture. It should be considered the treatment of choice for the urethral stricture with less than 2 cm length. More than twice operation is of limited value.