经尿道逆行腔内手术3580例报告

Transurethral retrograde surgery:a report of 3580 cases and literature review

目的:探讨应用经尿道逆行腔内手术微创治疗男性生殖泌尿道疾病的有效性。方法:对2008年6月至2014年6月在我院用内镜(精囊镜、尿道膀胱镜、输尿管肾镜)配合碎石器和切割器进行尿路狭窄切开、精囊扩张及冲洗、经尿道前列腺电切、膀胱肿瘤电切、尿路结石碎石取石和上尿路上皮肿瘤切除的3580例男性患者进行回顾性分析和文献综述。结果:135例尿路狭窄患者(上尿路33例,下尿路102例)中的131例(上尿路31例,下尿路100例),180例血精患者中的178例,全部512例前列腺增生和250例膀胱肿瘤患者,2482例尿路结石患者(上尿路结石2421例,下尿路结石61例)中的2476例(上尿路2415例,下尿路61例),以及21例上尿路上皮肿瘤患者中的5例手术均获成功。手术总成功率99.6%,总治愈率94.3%。结论:经尿道逆行腔内手术对尿路疾病进行治疗适用于泌尿系统绝大部分疾病,比其他学科具有天然的优势、并且创伤小,痛苦少,疗效好,恢复快,是泌尿外科的诊治方向。

[ Objective ]To explore the effectiveness of minimally invasive surgery operated by tmnsurethral relrograde approachin male with reproductive and urinary tract diseases. [Melhod]3580 male patients were included from June 2008 to June 2014.All the patients were treated respectively with urinary Ixact stenosis incision, seminal vesicle dilation and irrigation, transurethralelectroresection of prostate, electroresection of bladder tumors, lithoWipsy and exWaction of urinary calculi, upper urinary tractepithelial tumor resection through endoscope （seminal vesiculoscope, urethrocystoscope, ttreterorenoscope） in combination withlithotripter and cutter. The outcomes were relrospectively analyzed and the medical literature was reviewed. ~ Result ] Of 3580patients, 135 patients suffered from urinary tract stenosis （33 in upper urinary tract and 102 in lower urinary Iract）, 180 patientsfrom hematospennia, 512 patients from benign prostatic hyperplasia, 250 patients from bladder tumor, 2482 patients from uri-nary tract calculi （2421 in upper urinary Iract, 61 in lower urinary tract）, and 21 patients suffered from upper urinary tract ep-ithelial tumor. Of which, 131 patients with urinary tract stenosis （31 in upper urinary tract and 100 in lower urinary tract）, 178patients with hematospermia, all of 512 patients with benign prostatic hyperplasia and 250 patients with bladder tumor, 2476 pa-tients with urinary tract calculi （2415 in upper urinary tract and 61 in lower urinary tract）, and 5 patients with upper urinary tractepithelial tumor were successfully operated and effectively treated. The operation success rate was 99.6 % and the cure rate was94.3 %. [ Conclusion ] Transurethral retrograde was useful and superior to the other techniques in most of the urological diseaseswith advantages of minimal invasiveness, less pain, good efficacy and fast recovery. It is the direction of diagnosis and treat-ment in urology.