尿道内切开术治疗24例外伤性尿道狭窄

Treatment of traumatic urethral stricture with transurethral endoscopic incision:Report of 24 cases

目的探讨尿道内冷刀切开术治疗外伤性尿道狭窄的效果。方法 24例尿道狭窄患者,均采用尿道镜下经尿道内切开术治疗,现对其临床资料进行回顾性分析。结果 24例手术均顺利完成。术后随访6～12个月,14例术后排尿通畅。最大尿流率>15ml/s,8例术后出现尿流变细行定期尿道扩张,2例再狭窄者行二次尿道内切开手术治愈。结论尿道内切开术治疗尿道狭窄疗效可靠,具有创伤小、并发症少等优点,而且要求硬件条件低,适应于基层医院开展。尿道扩张可以巩固手术效果和降低狭窄复发率。

Objective To evaluate the transurethral endoscopic incision with cold knife in the treat- ment of traumatic urethral stricture. Methods 24 male patients with urethral stricture underwent internal urethrotomy using internal cold-knife. The clinial data were analyzed retrospectively. Results All opera- tions were accomplished successfully. For 6 to 12 months follow-up, 14 patients could void satisfactorily, the Qmax〉15 ml/s. Only 2 patients were reoperated for postoperative stenosis. There was no complication such as incontinence or urinary fistula in all cases postoperatively. All patients were accepted periodic ure- thral dilation according to the length of strictures postoperatively. Conclusion Transurethral endoscopic incision is a safe and egicient therapy which is mini-invasive and with fewer complications for traumatic urethral stricture, and it is appropriate for the basic hospital. Urethral dilation is important to decrease the postoperative re-stenosis.