后尿道损伤早期处理附30例报告

Early treatment of posterior urethral injury(report of 30 cases)

目的探讨后尿道损伤早期处理方式。方法总结我科30例后尿道损伤患者的临床资料,分析术后并发症及排尿情况。结果 30例患者中单纯膀胱穿刺造瘘术3例,留置导尿6例,输尿管镜下尿道会师术12例,尿道会师术6例,尿道修补吻合术3例,留置尿管2~6周,术后排尿良好10例（阳痿1例）,尿道狭窄14例（阳痿2例）,随访时间3月至84月,失访6例。结论输尿管镜下尿道会师术治疗后尿道损伤手术简单,创伤小,时间短,安全性高,具有较强的实用性,可是作为后尿道损伤首选治疗方法有待进一步证实。

Objective To investigate the early-treated method of posterior urethral injury. Methods A retrospective study was performed on 30 patients who presented, with traumatic injury to the posterior urethra, and the postoperative complic- ations and urination were analysed. Results 3 of 30 patients were treated with suprapubic punctual cystostomy, 6 cases with indwelling urethral catheter, 12 cases with ureterorenoscopic realignment, 6 cases with urethral reunion operation, 3 cases with repair and anastomosis of urethral injury; urinary catheter was removed within 2 - 6 weeks, and 10 cases of urination is good postoperatively （impotence 1 case）, urethral stricture 14 cases （impotence 3 case）, 24 cases of patients were followed up for 3 to 84 month, fail to be followed up 6 cases; Conclusion In respect of early treatment of posterior urethral injury, ureterorenoscopic realignment has the advantages of simplify, little trauma, short-operated time, high safety, and good practicability, but it should be needed further experiment to prove whether ureterorenoscopic realignment could be the first choice or not.