经会阴尿道吻合术治疗小儿外伤性后尿道狭窄闭锁

Urethral anastomosis via the perineal route for the treatment of traumatic posterior urethral stricture and obliteration in children

目的 评价小儿外伤性后尿道狭窄闭锁的处理方法及远期疗效。 方法 对 16例尿道狭窄及闭锁患儿行经会阴尿道吻合术 19例次 ,随访 2～ 2 1年 ,观察排尿 ,控尿及性功能情况。 结果16例患儿中 15例正常排尿 ,1例需定期尿道扩张 ,术后发生尿失禁 4例 (2 5 .0 % ) ,阳萎 3例(18.0 % ) ,4例尿失禁患儿随年龄增长症状有不同程度改善 ,3例阳萎病人病情无变化。 结论 对外伤性后尿道狭窄闭锁的患儿 ,伤后 6个月 ,首选经会阴尿道吻合术 ,正确的手术操作 。

Objective To evaluate urethral anastomosis via the perineal route in the treatment of traumatic posterior urethral stricture and obliteration in children. Methods 16 children with urethral stricture or obliteration were treated with urethral anastomosis via the perineal route and have been followed up for 2～21 years. Results Normal micturation has been observed in 15 whereas the other 1 needs periodical urethral dilatation.Incontinence occurred in 4 (25%) and impotence in 3 (18.0%).Urinary control improved with advancing age whereas impotency does not. Conclusions Urethral anastomosis via the perineal route should be attempted 6 months after injury for the treatment of traumatic posterior urethral stricture or obliteration.Fine anastomosis technique and adequate perioperative care are essential for a successful outcome.