钬激光尿道内切开治疗尿道狭窄:一项长期随访的结果

Holmium laser urethrotomy in treatment of urethral stricture:an outcome of long term follow-up

目的评价钬激光尿道内切开治疗尿道狭窄的远期疗效。方法回顾性分析该院2004～2006年钬激光尿道内切开治疗尿道狭窄32例患者的临床资料。32例患者狭窄段长度0.5～2.0cm,平均1.8cm。最大尿流率3.5～6.9mL/s,平均5.7mL/s。结果 32例患者术后拔除导尿管后均排尿通畅,复查最大尿流率18～28mL/s,平均19.2mL/s。随访60～70个月,平均61.4个月。30例患者尿道狭窄复发,最终行开放手术。其中12个月内无狭窄复发病例,24个月内16例复发,36个月内25例复发,48个月内28例复发,60个月内30例复发。结论钬激光尿道内切开治疗尿道狭窄,近期手术效果良好,但远期效果较差。

[Objective] To evaluate the efficacy of endoscopic holmium laser urethrotomy in the treatment of urethral stricture in a long term follow-up.[Methods] A retrospective analysis was made on the clinical data of 32 patients with urethral stricture which was shorter than 2cm.The average length of anterior urethral stricture was 1.8cm（range：0.5~2）,maximum flow rate of urine was 5.7 mL/s（range：3.5~6.9） respectively.All the patients underwent holmium laser urethrotomy under ureteroscopy or resectoscopy.The urethral scar tissues were resected by holmium laser and the succession of urethra was recovered.[Results] The maximum flow rate of urine was 19.2mL/s（range：18~28） after operation.With 60~70 months follow-up,urethral stricture recurred in 30 cases and required open surgery.[Conclusion] Resection of urethral scar tissues by endoscopic holmium laser urethrotomy is safe,convenient and minimally invasive in the treatment of urethral stricture and is effective in a short term.However,the result is poor in a long term follow-up.