输尿管镜等离子棒状电极顺行内切开治疗尿道狭窄

Ureteroscopic Antegrade Plasmakinetic Incision in the Treatment of Urethral Stricture

目的:探讨直视下输尿管镜等离子棒状电极顺行内切开治疗尿道狭窄的可行性。方法:在输尿管镜直视下,采用等离子棒状电极顺行内切开治疗尿道狭窄28例。将输尿管镜经过狭窄处置入膀胱后往回拖,用等离子棒状电极于尿道狭窄处4,8,12点切开至可通过F18号尿管即可。结果:25例获随访3～24月,平均15.4月,18例(72%)排尿通畅,因尿道狭窄复发有4例行2次,3例行3次内切开治疗,均无尿失禁和性功能障碍等,术后3～12月需定期扩尿道6例。结论:输尿管镜等离子棒状电极顺行内切开治疗尿道狭窄创伤小、安全性好,疗效肯定。

Objective：To evaluate the feasibility of antegrade plasmakinetic incision in the treatment of urethral stricture. Methods：Antegrade plasmakinetic incision was performed in 28 cases with urethral stricture. The ureteroscope was inserted the urethra and passed through the stricture into the bladder under direct vision, and than pulled out while an incision was made using bipolar plasmakinetie at the 4,8,12-o＇clock positions until a diameter of 18F catheter could pass through. Results： 25 cases were followed up at a mean time of 15.4 months （range 3 to 24）, 18（72%） ofthem have achieved satisfied results without complications of urinary incontinence and sexual dysfunction. Re-incision was performed two times in 4 and three times in 3 cases because of the recurrence of urethral stricture. Frequent and regular urethral dilation were performed in 6 cases range 3 to 12 months. Conclusions： Antegrade internal urethrotomy using the ureteroscope and bipolar plasmakinetic is a safe and easy method in the treatment of urethral stricture.