输尿管镜下钬激光联合筋膜扩张器治疗成年男性尿道狭窄合并下尿路结石的体会

Treatment for adult male urethral stricture complicated with calculus of lower urinary tract by using both renal sheath dilators and holmium laser under ureteroscope

目的探讨输尿管镜下钬激光联合筋膜扩张器治疗成年男性尿道狭窄合并下尿路结石的疗效和安全性。方法 8例尿道狭窄合并下尿路结石患者在输尿管镜直视下钬激光内切开,并用F8至F18筋膜扩张器扩张狭窄尿道并用钬激光经尿道碎石。结果 8例患者全部获得成功,无明显并发症,患者最大尿流率由治疗前3.5~9.0 m L/s上升至14~22 m L/s,随访3个月~1年,均未出现再次狭窄及结石复发。结论输尿管镜下钬激光联合筋膜扩张器治疗成年男性尿道狭窄合并下尿路结石疗效确切,安全性好。

Objective To explore the efficacy and security of urethral dilatation therapy for adult male urethral stricture complicated with calculus of lower urinary with renal sheath dilators and holmium laser under ureteroscope. Methods Eight cases with urethrostenosis complicated with calculus of lower urinary tract underwent dilatation and lithotripsy of urethra with renal sheath dilator and holmium laser. Under ureteroscope, the zebra guide wire was placed directly through stenosis into bladder,and with its guide,the urethral stenosis was dilated with F8-F18 renal sheath dilators gradually and with holmium laser urethrotomy, then holmium laser lithotripsy. Results The operation succeeded in all eight cases, and no severe complication such as urethral false passage occured. All cases were followed up from 3 to 12 months and no urethrostenosis recurred and stone recurrence. The maximum flow rates increased from 3.5 ~9.0 ml / s to 14-22 ml / s. Conclusion Dilatation of the urethrostenosis and lithotripsy with renal sheath dilators and holmium laser under ureteroscope is an efficient and safe method in the treatment of adult male urethrostenosis.