顺行引导下冷刀内切开联合电切术治疗尿道狭窄和闭锁(附31例)

目的探讨经尿道内口顺行引导冷刀切开联合电切术治疗尿道狭窄和闭锁的安全性和可行性。方法内窥镜下寻找正常通道困难的尿道狭窄和闭锁患者31例,狭窄长度1.0cm～3.5cm,平均1.9cm。均采用经尿道内口引导下冷刀切开联合电切术治疗。对手术时间、残余尿量(RUV)、最大尿流率(Qmax)以及随访情况进行分析。结果31例手术均顺利完成,手术时间35～83min,平均46min。拔导尿管后一周复查显示所有患者Qmax≥15ml/s、RUV≤40ml。25例患者随访6月～2年,23例患者排尿满意。结论对于内窥镜下寻找正常尿道通道困难的男性尿道狭窄和闭锁的患者,经尿道内口顺行引导下行狭窄部冷刀切开联合电切术安全有效、创伤小、手术成功率高。

Objective To evaluate the feasibility and efficacy of internal urethrotomy plus electrotomy for the treatment of urethral stricture and anterior. Methods 31 patients with urethral stricture and anterior, failed to find normal urethral under direct vision, were treated via internal urethrotomy plus electrotomy form May 2002 to May 2008. The clinical data and therapeutic efficiency were retrospectively analyzed. Results In all cases, the procedure achieved success and the operation time during was 35-83 min（mean 46 min）. The maximal flow rate was more than 15ml/ s and the residual urine volume was less than 40ml after catheter are removed for 1 week. 25 Patients were followed up form 6months to 2 years, and satisfactory voiding of 23 patients has been achieved. Conclusion Internal urethrotomy plus electrotomy is a simple, safe, effective and minimally invasive therapeutic technique for the treatment of urethral stricture and atresia.