经尿道双极动态等离子体汽化治疗尿道狭窄的临床应用探讨

Clinical Investigation of the Transurethral Bipolar Plasmakinetic Vaporization of Urethral Stricture

目的探讨经尿道双极动态等离子体汽化治疗尿道狭窄的安全性和有效性。方法采用经尿道双极动态等离子体汽化治疗尿道狭窄患者48例,术后随访36例6～18个月,观察临床效果。结果所有48例患者中有45例均一次手术成功,尿道瘢痕狭窄段得到准确切开,尿道可顺利通过F24～26探条,并保持排尿通畅;复发需二次手术者3例,行二次手术彻底切除瘢痕后获得成功;48例患者术后随访36例6～18个月,均排尿通畅,Qmax平均为(19.2±3.5)mL/s,较术前明显提高(P<0.05);手术前后性功能均无明显变化,未出现尿道大量出血、尿道穿孔、尿道憩室瘘、尿失禁、直肠损伤及假道形成等严重并发症。结论双极动态等离子体汽化电切术是治疗尿道狭窄的有效方法,具有创伤小、安全有效、操作简单、复发率低及重复性强等特点。

Objective To investigate the safety and effect of transurethral bipolar plasmakinetic vaporization of urethral stricture. Methods 48 patients with urethral stricture were operated by transurethral bipolar plasmakinetic vaporization, and 36 cases had been followed up to observe the clinical effects postoperatively. Results 45 cases were treated with transurethral bipolar plasmakinetic vaporization got one successful operation. The segments of urethral scar were accurately incised and resected. 24 - 26F bougies could pass through the urethra smoothly, and miction should be kept unobstructed. Recurrence required a second surgery in 3 cases, and second operation was successful af- ter complete resection of the scar. Totally 36 cases were followed up for 6 - 18 months postoperatively, the maximal flow rate was （19.2 ± 3.5） mL/s, which was significantly improved compared with the preoperative （P 〈0.05）. Sexual function had no obvious changes after operation; no serious complications was observed. Conclusions The transurethral bipolar plasmakinetic vaporization is an effective method for treating urethral stricture, because of its minimally invasion, safety, effection and simple operation, lower recurrence and repeatability.