2μm连续波激光治疗尿道狭窄及闭锁18例报告

Endoscopic Treatment of Urethral Stricture and Urethratresia with 2-μm Continuous-wave Thulium Laser

目的 探讨2 μm连续波激光治疗尿道狭窄及闭锁的安全性和有效性.方法 我院2010年1月-2013年8月使用2 μm连续波激光治疗15例尿道狭窄和3例尿道闭锁.激光切割镜直视下进入尿道狭窄处,2 μm连续波激光对狭窄处尿道进行切开,切开满意后使用尿道探子从细到粗逐号扩张尿道,然后留置尿管1根.结果 18例手术均获成功,无并发症发生.手术时间20-90 min,平均40 min.术中出血量5-20 ml,平均10 ml.留置导尿管4周,所有患者拔除尿管后全部排尿通畅.15例随访2-36个月,平均12个月,5例拔管后逐渐出现尿线变细,经定期尿道扩张后好转.结论 2 μm连续波激光治疗尿道狭窄及闭锁安全有效,可在临床中推广使用.

Objective To study the efficacy and safety of 2 - μm continuous-wave thulium laser for the treatment of urethral stricture and urethratresia. Methods Fifteen patients with urethral stricture and 3 patients with urethratresia underwent 2-μm continuous-wave thulium laser treatment from January 2010 to August 2013. The laser cystoscopy was placed into the urethra and 2-μm continuous-wave thulium laser was used to resect the urethral stenosis. Then urethral dilator was used to dilate the urethral stenosis, and finally a catheter was indwelled. Results All the operations were carried out successfully without complications. The operation time was 20 -90 min （mean, 40 min） ; blood loss was 5 -20 ml （mean, 10 ml）. Catheter retention for all the patients lasted for 4 weeks and urethra was unobstructed after the catheter was removed. Fifteen patients were followed up for 2 to 36 months （ mean, 12 months）. Urinary stream was getting weaker after removal of the catheter in five cases and improved after urethral dilatation. Conclusion The 2-μm continuous-wave thulium laser is safe and effective for the treatment of urethral stricture and urethratresia.