斑马导丝引导下尿道扩张治疗尿道狭窄28例分析

Urethral dilatation with zebra guidewire for the treatment of urethral strictures (report of 28 cases)

目的探讨在斑马导丝引导下应用筋膜扩张器或S形尿道扩张器行尿道扩张治疗尿道狭窄的临床效果。方法回顾性分析28例在斑马导丝引导下应用筋膜扩张器或S形尿道扩张器行尿道扩张治疗尿道狭窄病例的临床资料。结果 26例患者采用该种方法行尿道扩张成功,规律行尿道扩张8月后23例排尿通畅,最大尿流率大于15mL/s;3例患者仍排尿不畅,予以开放手术治疗。未成功的2例中,1例因尿道狭窄情况复杂而未能置入斑马导丝;1例患者置入斑马导丝后置入扩张器时阻力过大,无法通过;这2例患者均择期改行尿道成形术。26例扩张成功的患者无明显并发症。结论在斑马导丝引导下尿道扩张治疗尿道狭窄的方法具有损伤小、效果好、安全等优点,适用于传统尿道扩张失败的患者。

Objective To explore the clinical significance of urethral dilatation for urethral strictures treatment by using a renal sheath dilator or an S-shape dilator under the guidance of zebra guidewire. Methods Data of 28 patients with urethral strictures treated with urethral dilatation therapy which applied a renal sheath dilator or an S-shape divulsor under the guidance of zebra-guide wire were retrospective analyzed. Results The operation of urethral dilatation was successfully performed in 26 cases without significant complications. 8 months after regular urethral dilatation, 23 patients were cured; the maximum u- rine flow rate was more than 15 mL/s. 3 patients still suffered from obstruction and received urethroplasty. In the 2 unsuccess- ful cases, the zebra guidewire couldn＇t be implanted in 1 of them because of the complicated urethral stricture. As there was too much resistance after the dilator implantation, the other one failed due to the blockade after zebra guidewire implantation. Both of them received urethroplasty at another scheduled time. Oonclusions The method of curing urethral strictures through urethral dilatation by zebra urological guidewire is effective, safe and minimal invasive, which can be applied to pa- tients who have failed in the traditional urethra dilatation.