摘要
目的:探讨男性尿道狭窄的病因,分析近年来尿道狭窄治疗策略,并对复杂性病例进行总结。方法:回顾性分析183例尿道狭窄住院患者资料,包括病因、狭窄部位和长度、治疗策略和相关合并症等。结果:183例尿道狭窄患者平均年龄为49.7岁,以51~65岁人群居多(38.8%,71/183);平均病程为64.7个月。外伤性病因占52.4%(96/183),其中骨盆骨折者占35.5%(65/183)、骑跨伤者占16.9%(31/183);医源性损伤者占29.5%。后尿道狭窄占45.9%(84/183),前尿道狭窄占44.8%(82/183),多段狭窄有6.6%(12/183)。99例(54.1%)接受了尿道狭窄段切除端端吻合术;40例(21.9%)接受腔内手术治疗,包括内窥镜下钬激光、冷刀内切开、内窥镜下电刀瘢痕切除、球囊扩张和尿道扩张术等。>65岁尿道狭窄患者27例(14.7%),经尿道前列腺电切术(transurethral resection of the prostate,TURP)术后并发尿道狭窄的比例达70.4%,显著高于整体样本的发生率(P<0.01)。结论:近3年男性外伤性和医源性尿道狭窄发生率有所增加。治疗方式从以内窥镜手术为主转变成以尿道成形术为主。
Objective: To explore the etiology of male urethral stricture, analyze the therapeutic strategies of urethral stricture, and summarize the complicated cases.Methods: Th e data of 183 patients with urethral stricture were retrospectively analyzed, including etiology, obstruction site, stricture length, therapeutic strategy, and related complications.Results: Th e mean age was 49.7 years, the average course was 64.7 months, and the constituent ratio of 51 to 65 years old patients was 38.8% (71/183). The traumatic injury of patients accounted for 52.4% (96/183), in which the pelvic fracture accounted for 35.5% (65/183) and the straddle injury accounted for 16.9% (31/183). There were 54 cases of iatrogenic injury (29.5%). The posterior urethral stricture accounted for 45.9% (84/183), followed by the anterior urethral stricture (44.8%, 82/183) and the stenosis (6.6%, 12/183). A total of 99 patients (54.1%) received the end to end anastomosis, and 40 (21.9%) were treated with intracavitary surgery, such as endoscopic holmium laser, cold knife incision, endoscopic electroknife scar removal, balloon dilation, and urethral dilation. In the patients over 65-years old, the urethral stricture rate was 14.8% and the complication rate (70.4%) for transurethral resection of the prostate (TURP) was significantly higher than that of all samples (P〈0.01).Conclusion: Both the etiology of male urethral stricture and the treatment strategy have changed and the incidence of traumatic and iatrogenic urethral stricture has increased in recent 3 years. The main treatment of urethral stricture has been transformed from endoscopic surgery into urethroplasty.
作者
陈彩芳
曾铭强
薛睿智
王桂林
高智勇
袁武雄
唐正严
CHEN Caifang;ZENG Mingqiang;XUE Ruizhi;WANG Guilin;GAO Zhiyong;YUAN Wuxiong;TANG Zhengyan(Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha 410008;Department of Urology, Hunan Provincial People's Hospital;First Affi liated Hospital of Hunan Normal University, Changsha 41000;3. Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China)
出处
《中南大学学报(医学版)》
CAS
CSCD
北大核心
2018年第5期520-527,共8页
Journal of Central South University :Medical Science
基金
国家自然科学基金(81570627)
湖南省科技厅重点研发计划(2016JC2044)
湖南省卫生和计划生育委员会科研课题(20180501)~~
关键词
尿道狭窄
治疗
病因
男性
urethral stricture
treatment
etiology
male