改良尿道套入术治疗复杂性后尿道狭窄或闭锁疗效分析

Modified Urethral Pull-through Procedure in Complex Posterior Urethral Stricture

目的探讨改良尿道套入术治疗复杂性后尿道狭窄或闭锁的临床疗效。方法选取我院71例行改良尿道套入术治疗的复杂性后尿道狭窄或闭锁患者,狭窄或闭锁段长3～10cm。62例曾有1～4次手术史。67例经会阴或腹会阴切口,4例经耻骨或切除部分耻骨下缘切口。14例应用游离包皮内板和(或)膀胱黏膜进行尿道替代成形。结果 67例(94.4%)拔管后排尿较满意,其中61例无需尿道扩张,6例尿道扩张3～8次后恢复正常;4例失败。性功能改善7例,恶化2例,余无明显变化。会阴部切口感染3例。结论改良尿道套入术治疗复杂性后尿道狭窄或闭锁是可行的、安全的,具有创伤小、操作简便、成功率高等优点。

Objective To investigate effects of modified urethral pull-through procedure in treatment of complex posterior urethral stricture or atresia.Methods A retrospective analysis was performed on clinical data of 71 patients with complex posterior urethral stricture or atresia（with a stricture or atresia length of 3～10 cm）undergoing modified urethral pull-through procedure.Sixty-two had had 1～4 surgeries.Sixty-seven patients had trans-perineal or-abdominal perineal incisions,4 had trans-or inferior-pubic incisions,and 14 had urethral construction with free prepuce and（or）bladder mucosa.Results Sixty-seven patients（94.4%）had relatively satisfactory voiding after extubation,among whom 61 did not need urethral dilation,6 returned to normal after 3～8 dilations.Four patients failed.Improved sexual function was noted in 7,aggravation in 2,no changes in others.Three had infected perineal incisions.Conclusion Modified urethral pull-through procedure in treatment of complex posterior urethral stricture is feasible,safe,less invasive,simple,with a high success rate.