肾筋膜扩张器配合输尿管镜在男性输尿管壁段狭窄诊疗中的临床应用

Clinical Application of Ureteroscopy Combined with Renal Sheath Dilator in the Treatment of Male Low Ureteral Stricture

目的探讨肾筋膜扩张器配合输尿管镜在男性输尿管壁段狭窄诊疗中的应用价值。方法 2010年10月~2014年10月,在30例男性输尿管镜手术中,因输尿管壁内段狭窄或输尿管口粘连,采用肾筋膜扩张器行狭窄逐级扩张。用F8~F12肾筋膜扩张器套装,在导丝引导下由F8扩张器开始依次递增进行扩张,每次扩张3 min,每次增加2个F号码,扩张至F12时,再次尝试入镜。结果采用肾筋膜扩张器处理后,25例进镜成功,5例效果不明显。术中未出现筋膜扩张器扩张相关并发症。结论肾筋膜扩张器在男性输尿管镜术中处理输尿管口粘连或壁内段狭窄,具有临床效果良好、安全、简便、有效的优势。

Objective To explore the clinical application of ureteroscopy combined with renal sheath dilator in the treatment of male low ureteral stricture. Methods From October 2010 to October 2014,30 male patients with ureteral intramural segment stricture or ureteric orifice adhesion underwent ureteral dilatation with the renal sheath dilator under ureteroscope. Under the ureteroscope,a guide wire was placed into the ureter via urethra. The renal sheath dilator guided by the wire was inserted serially to dilate the ureteral stricture from F8 to F12under ureteroscope monitoring. The dilation time was 3 min at once. After F12 renal sheath dilator was drawn,the ureteroscope was placed again. Results Among the 30 cases,the operation was successfully performed in 25 cases and failed in 5 cases. During the operation,no complication related to sheath dilatation happened. Conclusion Treatment of male low ureteral stricture with renal sheath dilator under ureteroscopy is a simple,safe,and effective method.