输尿管镜RevoLix 2 μm激光内切开术联合球囊扩张导管治疗复发性尿道狭窄

Joint Treatment of Recurrent Urethral Stricture with Transurethral RevoLix 2 μm Laser Urethrotomy and Balloon Dilatation Catheter

目的探讨应用输尿镜RevoLix 2μ m激光内切开术联合球囊扩张导管在治疗复发性尿道狭窄中的临床疗效。方法复发性尿道狭窄24例,采用输尿管镜RevoLix 2 μm激光行尿道内切开,汽化切除复发的尿道瘢痕组织,并应用球囊扩张导管一次性扩张尿道狭窄段,观察术后疗效。结果 24例患者均手术顺利,手术时间15~80 min,平均40 min,术后2~6周拔除尿管均能即刻排尿,无严重并发症出现,术后随访3~16个月,其中23例行规律扩尿道后维持正常排尿,仅1例尿道扩张失败后行尿道狭窄段切除术。结论输尿镜RevoLix 2 μm激光内切开术联合球囊扩张导管在治疗男性复发性尿道狭窄中操作简单安全有效,并发症少、成功率高,可作为复发性尿道狭窄患者的治疗手段,但其远期疗效仍需观察。

Objective To evaluate the clinical effect of the joint application of RevoLix 2 μm laser urethrotomy and balloon dilation in treating re- current urethral stricture. Methods Totally 24 patients of recurrent urethral stricture or atresia were given endourethrotomy with RevoLix 2 μm laser, their ure- thral scar tissues were removed with vaporization, the continuity of the urethra was restored, a balloon dilatation catheter was applied in one-time dilation of urethral stricture and the clinical effects and complications were observed. Results All of the 24 patients were given a successful operation. The mean operation time was 40 min, ranging from 15 to 80 min. Im- mediate urination was achieved after 2-6 weeks of catheter indwelling, and no severe complication occurred. The patients were followed up for 3-16 months. Except one patient having to receive open urethroplasty, the rest 23 patients had normal urination after regular ure-thral dilation. Conclusions Combined application of RevoLix 2 μm laser urethrotomy and balloon dilatation catheter is a safe, effective and mini- mally invasive option for recurrent urethral stricture. It is also suitable for severe urethral stricture and urethral atresia. Featuring a high success rate, it will also reduce the postoperative pain of patients with urethral dilation. Despite of a satisfactory short-term outcome, the long-term effect of the approach should be further observed.