输尿管镜下尿道会师术治疗尿道损伤

Urethral realignment for treating early urethral injury under the guidance of ureteroscope

目的 总结输尿管镜下尿道会师术治疗尿道损伤的临床经验,并评价其疗效.方法 选择29例男性尿道损伤患者,后尿道损伤12例,前尿道损伤17例,均采用输尿管镜下尿道会师术,术后留置导尿管3～8周,每7～16d更换管径增大2F的导尿管1次.结果 29例尿道损伤患者一次留置导尿管成功,全部患者术后3个月无尿失禁存在;29例患者中,27例拔除导尿管后排尿通畅,2例2周后尿线变细,经短程尿道扩张后,排尿正常.结论 采用输尿管镜下尿道会师术治疗尿道损伤,术式简洁、并发症少、恢复快、效果好,术后持续柔性渐进性尿道扩张及严格护理,可有效减少尿道狭窄的发生.

Objective To summarize the clinical experience of urethral realignment for treating early urethral injury under the guidance of ureteroscope,and evaluate its curative effect.Methods Twenty-nine male patients with urethral injury were selected,and 12 patients of posterior urethral injury,17 patients of former urethral injury.All the patients were treated with urethral realignment under the guidance of ureteroscope,postoperative indwelling catheter 3-8 weeks,every 7-16 days changed diameter increase 2 F the catheter 1 time.Results The 29 patients with urethral injury were a indwelling catheter success,all patients were no incontinence after operation 3 months.In the 29 patients,27 patients were urination unobstructed after catheter removal,2 patients were appeared urine line slim after 2 weeks,the 2 patients were normal urination after short urethral expansion.Conclusions The urethral realignment for treating early urethral injury under the guidance of ureteroscope has simple,lower complication,rapid recovery,better effect.The continuous flexible progressive urethral expansion and the strict nursing,which can effectively reduce the occurrence of urethral stricture.