膀胱尿道软镜配合筋膜扩张器治疗单纯性尿道狭窄疗效分析

The electron flexible cystourethroscope combined with a fascia dilator for simple urethral stricture

目的探讨膀胱尿道软镜配合筋膜扩张器治疗单纯性尿道狭窄的临床疗效。方法回顾性分析自2008年10月至2010年10月,使用膀胱尿道软镜配合筋膜扩张器治疗80例单纯性尿道狭窄患者的过程。分析患者尿道狭窄类型、术后留置尿管时间、术后并发症及预后,评估该手术方式治疗单纯性尿道狭窄的疗效,并对手术技巧及术后处理进行总结。结果 78例患者一次扩张成功,手术时间7～12 min,平均9 min,无尿道穿孔、尿道撕裂及假道形成等并发症;2例因瘢痕质硬及狭窄段较长扩张失败,最终改行绿激光汽化术治疗。术后随访4～24个月,64例患者随访至今,56例患者经不同次数尿道扩张后,至今排尿情况良好;8例患者因狭窄段瘢痕质硬及扩张后瘢痕缩窄迅速,反复出现尿线变细、排尿困难最终改行绿激光手术治疗。结论膀胱尿道软镜配合筋膜扩张器是治疗单纯性尿道狭窄简单、安全、有效的方法。

cystourethroscope combined with a fascia dilator to treat simple urethral stricture. Methods 80 patients with simple urethral stricture confirmed by physical examination and radiology underwent urethral dilation with the electron flexible cystourethroscope combined with a fasci- a dilator in our center. The outcomes were retrospectively analyzed in accordance with the stricture pattern, catheteriza- tion duration time and prognosis. Results 78 cases were successfully performed with urethral dilation without serious complications. The median time was 9 min （7 to 12 min）. 64 patients were followed up （4 to 24 months）. And 8 pa- tients underwent the photo-selective vaporization of urethral stricture due to stubborn restenosis and personal delay of treatment. Conclusion The electron flexible cystourethroscope combined with a fascia dilator in the treatment of sim- ple urethral stricture demonstrates satisfactory safety, briefness and efficacy.