尿道狭窄及闭锁的腔内手术治疗体会(附62例报告)

Endourethral surgery for urethrostenosis and urethratresia(report of 62 cases)

目的 提高尿道狭窄及闭锁的腔内手术成功率。 方法 总结 6 2例尿道内切开、经尿道瘢痕电切或激光切除术治疗尿道狭窄或闭锁的经验。 结果 6 0例 (97% )手术成功 ,其中 4例行2或 3次腔内手术。 2例 (3 % )手术失败者与狭窄段长及术后感染有关。 5 3例随访 8～ 132个月 ,平均 32个月 ,均排尿通畅。 结论 术前准确了解尿道狭窄段状况 ,积极处理并发症 ;术中冷刀沿正道切开 ,并充分切开瘢痕 ,热刀或激光彻底去除瘢痕 ;术后积极预防感染 ,正确留置导尿管是手术成功的重要保证。

Objective To evaluate the endourethral surgery for urethrostenosis and urethratresia. Methods 62 patients suffering from urethrostenosis or urethratresia were treated by endourethral surgery, such as interal urethrotomy, transurethral scar electrosectomy and transurethral laser cicatrectomy. Some experiences were learned and summed up. Results The success rate in this series was 97%(60/62). Recurrence was observed in 4 patients and transurethral urethrotomy was carried out twice or three times with success. The causes of 2 failures were due to long-segment stricture and post-operation infection. 53 patients have been followed up for 8～132 months with a mean of 32 months . Satisfactory voiding has been achieved in all. Conclusions Endourethral surgery is a safe and efficient treatment for urethrostenosis and urethratresia. The success of the treatment depends on a few key points. Firstly,the stenosed segment of urethra should be thoroughly understood and complications should be cured before surgery. Secondly, during operation, the stricture should be incised along the true urethra tract with cold-knife. The scar should be incised completely and resected thoroughly by electric or laser technique. Finally, in the post- operation period,infection should be prevented and the urethral catheterization should be managed appropriately.