顺行导丝引导逆行扩张治疗尿道成形术后早期狭窄

Antegrade insertion of guide wire through suprapubic fistula facilitates retrograde dilation for treatment of early stricture following urethroplasty

目的探讨经尿道外口逆行导丝置入失败后,经耻骨上造瘘口顺行置入导丝引导逆行尿道扩张治疗尿道成形术后早期狭窄的可行性及安全性。方法对13例逆行导丝置入失败的尿道成形术后早期狭窄患者经耻骨上造瘘口置入膀胱软镜,经膀胱软镜将斑马导丝穿过尿道狭窄段,引导扩张鞘行逆行扩张。结果 13例均获成功,平均操作时间为(10.7±3.18)min(8～17 min),无严重并发症发生。结论顺行导丝引导逆行尿路扩张是治疗尿道成形术后早期狭窄的安全有效的方法。

Objective To discuss the feasibility and safety of a novel urethral dilation procedure using antegrade insertion of guide wire through suprapubic fistula（retrograde insertion failed） to facilitate retrograde dilation for treating early stricture following urethroplasty.Methods Thirteen patients,who failed to receive retrograde insertion,developed early stricture following urethroplasty.The guide wire was inserted through a pre-made suprapubic fistula to pass the stricture with the help of flexible cystoscope.Then the guide wire was used to guide polytef catheter to perform retrograde dilation.Results The procedures were successfully done in all the 13 patients.The mean operation time was（10.7 ± 3.18） min（8-17 min）,and there were no serious complications.Conclusion The present dilation procedure is an effective and safe method for management of early stricture recurrence following urethroplasty.