腔镜下钬激光治疗长段尿道闭锁临床体会

Endoscopic holmium laser urethrotomy for the treatment of urethral occlusion

目的 探讨尿道长段闭锁的微创腔内钬激光治疗方法和经验.方法 73例尿道长段闭锁患者,在膀胱镜、输尿管镜或前列腺切除镜下,利用钬激光行尿道内切开,切除尿道瘢痕组织,恢复尿道的连续性.术后出现尿道狭窄者,给予尿道扩张.结果 73例尿道长段闭锁患者均一次性手术解除闭锁,术后2例因未及时行尿道扩张再次手术,31例行尿道扩张1～6次均排尿道畅.未发现尿道严重出血、穿孔、尿失禁、勃起功能障碍等并发症. 结论应用钬激光行尿道瘢痕切除手术治疗尿道长段闭锁,安全高效,手术创伤小,并发症少,住院时间短.

Objective To evaluate the efficacy of endoscopic holmium laser urethrotomy in the treatment of urethral occlusion. Methods A retrospective analysis was made on the clinical data of 73 patients with urethral occlusion which was greater than 2 cm. All the patients underwent holmium laser urethrotomy under cystoscopy, ureteroseopy, or resectoscopy. The urethral scar tissues were reseeted by holmium laser and the succession of the urethra was recovered. Results The urethral scar tissues in all the patients were resected successfully by using holmium laser. Two patients who were not given urethral dilatation in time received the second urethrotomy by using holmium laser. Thirty - one patients voided normally after urethral dilatation 1 - 6 times. No severe complications such as massive hemorrhage, urethral perforation, urinary incontinence,rectal injury, or erectile dysfunction occurred. Conclusion Resection of urethral sear tissues by endoscopic holmium laser urethrotomy is safe, convenient and minimally invasive in the treatment of urethral occlusion.